Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2020 Mar 15;34(4):549-558.
doi: 10.1097/QAD.0000000000002444.

Impact of HIV and antiretroviral drug exposure on lung growth and function over 2 years in an African Birth Cohort

Diane M Gray  1 , Catherine J Wedderburn  1   2 , Rae P MacGinty  1 , Lauren McMillan  1 , Carvern Jacobs  1 , Jacob A M Stadler  1 , Graham L Hall  3 , Heather J Zar  1
Affiliations
Observational Study

Impact of HIV and antiretroviral drug exposure on lung growth and function over 2 years in an African Birth Cohort

Diane M Gray et al. AIDS. .

Abstract

Objective: To assess the impact of HIV and antiretroviral exposure without infection on lung growth and function over the first 2 years of life.

Design: Prospective observational study of an African birth cohort, Drakenstein Child Health Study.

Method: Infants enrolled antenatally had lung function measured at 6 weeks, 1 and 2 years. HIV-infected women received antiretroviral therapy (ART) as per local guidelines. The association between HIV and antiretroviral exposure with lung function was assessed using mixed effects modelling.

Results: Of 1143 infants born, two HIV-infected infants were excluded from analysis; 909 (80%) infants had lung function collected at 6 weeks [190 (21%) were HIV-exposed uninfected (HEU)]; 782 (69%) at 1 year and 741 (65%) at 2 years. At 6 weeks HEU infants had larger tidal volume compared with HIV-unexposed infants (1.13 ml, confidence interval: 0.02-2.23, P = 0.045). High maternal viral load was associated with a 17% lower expiratory flow over 2 years (0.17, confidence interval 0.00-0.34, P = 0.046). First-line ART initiated during pregnancy was associated with lower infant tidal volume at 6 weeks compared with those who initiated ART before pregnancy (-2.7 ml, -5.31 to -0.10, P = 0.042), and low maternal CD4 cell counts associated with lower infant tidal over 2 years (-11.1 ml, -18.58-3.58, P = 0.004).

Conclusion: HIV exposure is associated with altered lung function in early life, with a vulnerable HEU subgroup based on maternal disease severity, immunological compromise and ART exposure. These data highlight the importance of ongoing surveillance of respiratory health in HEU children.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Fig. 1
Fig. 1
Flow chart of cohort (include number included at each time point with successful testing).
See this image and copyright information in PMC

References

    1. WHO. Causes of child mortality, 2017. 2017; Geneva, Switzerland: WHO, Available at https://www.who.int/gho/child_health/mortality/causes/en /.
    1. WHO. Children: reducing mortality. Geneva, Switzerland: WHO; 2018.
    1. Bamford LJ, McKerrow NH, Barron P, Aung Y. Child mortality in South Africa: fewer deaths but better data are needed. S Afr Med J 2018; 108:s25–s32.
    1. UNICEF. Statistical update 2015. Available at https://data.unicef.org/resources/children-aids-2015-statistical-update-2/
    1. UNAIDS. 2015 Progress report on the global plan: towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive. Geneva, Switzerland: UNAIDS Publications; 2015. - PubMed

Publication types

Substances

LinkOut - more resources