Premium
Risk factors for the development of bronchiectasis in HIV‐infected children
Author(s) -
Berman David M.,
Mafut Damaris,
Djokic Boris,
Scott Gwendolyn,
Mitchell Charles
Publication year - 2007
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.20668
Subject(s) - bronchiectasis , medicine , pneumonia , immunosuppression , pediatrics , pneumonitis , medical record , risk factor , retrospective cohort study , lung
Our objective was to describe the risk factors for the development of bronchiectasis in HIV‐1 infected children. This study was a retrospective, case controlled study based upon medical record review of HIV‐1 infected children receiving primary care at a single large, urban medical center in Miami, Florida. Cases (HIV‐1 infected children who developed bronchiectasis while being cared for between January 1982 and September 2000) were matched 1:3 (birth ± 24 months) with controls (HIV‐1 infected children without bronchiectasis). Variables analyzed including number of episodes of pneumonia (including Pneumocystis jiroveci pneumonitis [PCP], lymphoid interstitial pneumonitis (LIP), and CDC category of immunosuppression) were noted in both cases and controls until the age at which the cases developed bronchiectasis. Of the 749 patients whose charts were reviewed, 43 met the case definition for bronchiectasis and 19 met the eligibility criteria for this study. Fifty‐seven controls were randomly selected from the patients without bronchiectasis. Cases were more likely to have experienced recurrent pneumonia than the controls; 17 (89.5%) versus 5 children (8.8%) respectively ( P ‐value ≤0.001) as well as a greater mean number of episodes of pneumonia 8.2 (range, 4–13) versus 1.45 (range, 0–9) respectively (CI = (5.58,7.82); P ‐value ≤0.001). Cases were more likely to have progressed to CDC immunological category 3 than the controls; 19 (100%) versus 32 (56%) children respectively ( P ‐value <0.001). LIP occurred more frequently in the cases than in the controls; 14/19 (73.6%) versus 19/57 (33.3%), respectively ( P ‐value = 0.005). HIV‐1 infected children with a history of recurrent pneumonia, profound immuno‐suppression (CDC immunologic category 3), and LIP appear to have a higher risk of developing bronchiectasis. Pediatr Pulmonol. 2007; 42:871–875. © 2007 Wiley‐Liss, Inc.