Pulmonary Function in HIV-1 Vertically Infected Children

Background: Despite reports of an increasing incidence of asthma in HIV-infected children, exploration of pulmonary function by spirometry has never been reported in this population in the HAART era. Objective: The aim of this study was to determine the prevalence of spirometric abnormalities in HIV-1 infected children. We conducted a cross-sectional study of pulmonary function tests (PFT) in HIV-1 vertically infected children. Methods: Spirometric values were measured in 17 HIV-1 chronically infected children and compared to matched healthy children. In HIV-1 infected children, the correlations between PFT and the determination of the single breath carbon monoxide diffusing capacity of the lung (TL CO ) and immunological and virological values were assessed. Results: Overall, 11 of the 17 PFT were normal. Four showed mild distal obstruction. Two were considered restrictive. When compared with matched healthy children, the only difference was the FEV1/FVC ratio that was significantly lower in the patients’ group (91.9% of predicted value versus 97.1%, p<0.0001). We found a positive correlation between TL CO and the CD4/CD8 T-cell ratio (p=0.012) and viral load (p=0.05). We observed that FEF 25-75 values increased with age and weight in healthy children (p= 0.006 and p=0.007 respectively), but not in infected patients. Conclusions: Our results showed that chronic HIV-1 infection and/or continuous HAART exposure induce a specific response of the pulmonary immune system which may compromise its function with time. If confirmed, it may justify a careful follow-up of pulmonary function in vertically infected children