Teen Lungs Thrive With Prompt HIV Care in Childhood

TOPLINE:

Early antiretroviral therapy (ART) initiation in children with perinatal HIV (CHIV) preserves lung function into the second decade of life, with most children maintaining virologic suppression.

METHODOLOGY:

• Researchers conducted a prospective study to understand the effects of early diagnosis and ART initiation on HIV-associated lung disease into the second decade of life in CHIV.
• They followed 102 CHIV between September 2013 and March 2020 who initiated ART early (median age at initiation, 9 weeks) alongside 129 age-matched children without HIV (including those exposed but uninfected and those unexposed).
• The primary outcome was the comparison of pulmonary function testing (PFT) indices between 72 CHIV (median age at PFT, 12.6 years) and 38 children without HIV (median age at PFT, 13.2 years) during their second decade of life.
• The secondary outcomes involved the risks for predefined pulmonary function abnormalities such as airflow limitation, diminished lung volume, and airway dysfunction.

TAKEAWAY:

• Overall, 94.2% of CHIV maintained virologic suppression at the time of PFT.
• No significant differences were noted in spirometry outcomes or lung volumes between CHIV and children without HIV.
• Small airway dysfunction occurred in 11.27% of CHIV, whereas it was seen in 2.7% of children without HIV (absolute risk difference, 0.09; 95% CI, −0.06 to 0.19).
• None of the predetermined HIV-associated variables showed correlation with PFT outcomes in the second decade of life.

IN PRACTICE:

“We demonstrate that early ART combined with high-quality, basic medical care throughout childhood may mitigate the effect of perinatal HIV on children’s lung health,” the authors wrote.

SOURCE:

The study was led by Andre Gie, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa. It was published online on December 16, 2024, in the American Journal of Respiratory and Critical Care Medicine.

LIMITATIONS:

The study findings might not be generalizable to other healthcare settings due to differences in access to healthcare facilities, which could influence HIV-related factors linked to pulmonary function test outcomes. Additional limitations included early mortality within the parent trial; significant loss to follow-up, particularly among children without HIV; and limited investigation of small airway function.

DISCLOSURES:

This study was supported through research grants from the Collaborative Initiative for Paediatric HIV Education and Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, South African Medical Research Council, and South African National Research Foundation. Two authors reported receiving research grants from various institutions.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.