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Free Content HIV-related bronchiectasis in children: an emerging spectre in high tuberculosis burden areas

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Abstract:

BACKGROUND: Human immunodeficiency virus (HIV) infected children have an eleven-fold risk of acute lower respiratory tract infection. This places HIV-infected children at risk of airway destruction and bronchiectasis.

OBJECTIVE: To study predisposing factors for the development of bronchiectasis in a developing world setting.

METHODS: Children with HIV-related bronchiectasis aged 6–14 years were enrolled. Data were collected on demographics, induced sputum for tuberculosis, respiratory viruses (respiratory syncytial virus), influenza A and B, parainfluenza 1–3, adenovirus and cytomegalovirus), bacteriology and cytokines. Spirometry was performed. Blood samples were obtained for HIV staging, immunoglobulins, immunoCAP┬«-specific immunoglobulin E (IgE) for common foods and aeroallergens and cytokines.

RESULTS: In all, 35 patients were enrolled in the study. Of 161 sputum samples, the predominant organisms cultured were Haemophilus influenzae and parainfluenzae (49%). The median forced expiratory volume in 1 second of all patients was 53%. Interleukin-8 was the predominant cytokine in sputum and serum. The median IgE level was 770 kU/l; however, this did not seem to be related to atopy; 36% were exposed to environmental tobacco smoke, with no correlation between exposure and CD4 count.

CONCLUSION: Children with HIV-related bronchiectasis are diagnosed after the age of 6 years and suffer significant morbidity. Immune stimulation mechanisms in these children are intact despite the level of immunosuppression.

Keywords: bronchiectasis; cytokines; human immunodeficiency virus; paediatrics; tuberculosis

Document Type: Research Article

DOI: http://dx.doi.org/10.5588/ijtld.11.0244

Affiliations: 1: Department of Paediatrics and Child Health, Division of Paediatric Pulmonology, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa 2: Department of Immunology, University of Pretoria, Pretoria, South Africa 3: Biostatistics Unit, Medical Research Council of South Africa, Pretoria, South Africa

Publication date: January 1, 2012

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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