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Bronchiectasis and other chronic lung diseases in adolescents living with HIV

Attia, EF; Miller, RF; Ferrand, RA; (2017) Bronchiectasis and other chronic lung diseases in adolescents living with HIV. Current Opinion in Infectious Diseases , 30 (1) pp. 21-30. 10.1097/QCO.0000000000000325. Green open access

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Abstract

Purpose of review The incidence of pulmonary infections has declined dramatically with improved access to antiretroviral therapy (ART) and cotrimoxazole prophylaxis, but chronic lung disease (CLD) is an increasingly recognized but poorly understood complication in adolescents with perinatally acquired HIV. Recent findings There is a high prevalence of chronic respiratory symptoms, abnormal spirometry and chest radiographic abnormalities among HIV-infected adolescents in sub-Saharan Africa, wherein 90% of the world's HIV-infected children live. The incidence of lymphocytic interstitial pneumonitis, the most common cause of CLD in the pre-ART era, has declined with increased ART access. Small airways disease, particularly constrictive obliterative bronchiolitis and bronchiectasis, are emerging as leading causes of CLD among HIV-infected adolescents in low-income and middle-income countries. Asthma may be more common in high-income settings. Likely risk factors for CLD include recurrent pulmonary infections, air pollution, HIV-related immune dysfunction, and untreated HIV infection, particularly during critical stages of lung development. Summary Globally, the importance of HIV-associated CLD as a cause of morbidity and mortality is increasing, especially as survival has improved dramatically with ART and growing numbers of children living with HIV enter adolescence. Further research is urgently needed to elucidate the natural history and pathogenesis of CLD, and to determine optimal screening, diagnostic and treatment strategies.

Type: Article
Title: Bronchiectasis and other chronic lung diseases in adolescents living with HIV
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/QCO.0000000000000325
Publisher version: https://doi.org/10.1097/QCO.0000000000000325
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Infectious Diseases, adolescent, bronchiectasis, chronic lung disease, HIV, lymphocytic interstitial pneumonitis, obliterative bronchiolitis, HUMAN-IMMUNODEFICIENCY-VIRUS, COMBINATION ANTIRETROVIRAL THERAPY, MIDDLE-INCOME COUNTRIES, INFECTED CHILDREN, AFRICAN CHILDREN, RESPIRATORY-INFECTIONS, MONOCYTE ACTIVATION, PULMONARY-DISEASE, DELAYED DIAGNOSIS, OLDER CHILDREN
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10044741
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