TOPLINE:
Early initiation of antiretroviral therapy (ART) in children with perinatal HIV (CHIV) helps preserve their lung function well into their second decade of life, with the majority achieving and maintaining virologic suppression.
METHODOLOGY:
A prospective study was conducted to investigate the impact of early HIV diagnosis and ART initiation on lung health in CHIV children through their second decade of life. Researchers followed 102 CHIV patients who started ART at a median age of 9 weeks, alongside 129 age-matched children without HIV, including both those exposed but uninfected and those entirely unexposed.
The primary focus of the study involved comparing pulmonary function testing (PFT) results between 72 CHIV children (median age at PFT: 12.6 years) and 38 healthy children (median age at PFT: 13.2 years). Secondary outcomes examined specific pulmonary function abnormalities, including airflow limitation, reduced lung volumes, and airway dysfunction.
KEY FINDINGS:
The research revealed that 94.2% of CHIV children maintained virologic suppression at the time of their PFT. No significant differences were observed in spirometry outcomes or lung volumes between CHIV patients and those without HIV.
However, a slight difference was noted in small airway dysfunction, which occurred in 11.27% of CHIV children compared to 2.7% of children without HIV. The absolute risk difference between the two groups was 0.09 (95% CI, −0.06 to 0.19).
Interestingly, no predefined HIV-related factors correlated with the PFT outcomes in the second decade of life.
IMPLICATIONS FOR PRACTICE:
The findings suggest that implementing early ART combined with high-quality, basic medical care throughout childhood can help mitigate the effects of perinatal HIV on children’s lung health. This approach provides a robust foundation for long-term respiratory well-being in children with HIV.
LIMITATIONS:
While the study provides valuable insights, it is important to note potential limitations. The study’s findings may not be generalizable to all populations due to the specific geographic and demographic context of the research.
DISCLOSURES:
The research was financially supported by grants from the Collaborative Initiative for Paediatric HIV Education and Research, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the South African Medical Research Council, and the South African National Research Foundation. Two of the study authors reported receiving research grants from various institutions.
CONCLUSION:
Early antiretroviral therapy in children with perinatal HIV not only helps maintain healthy viral levels but also preserves their lung function into their teen years. This comprehensive approach underscores the importance of early intervention and ongoing care in improving the long-term health outcomes of CHIV children.
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