Chronic radiographic lung changes in children with vertically transmitted HIV-1 infection

K. I. Norton, M. Kattan, Jonnagadda S Rao, R. Cleveland, L. Trautwein, R. B. Mellins, W. Berdon, M. I. Boechat, B. Wood, M. Meziane, A. C G Platzker

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

OBJECTIVE. We prospectively studied children with and without maternally transmitted HIV-1 infection born to mothers infected with HIV-1 to determine the incidence of chronic radiographic lung changes (CRC) and to correlate these changes with clinical assessments. SUBJECTS AND METHODS. Between 1990 and 1997, we scored 3050 chest radiographs using a standardized form. Group I children (n = 201) were HIV- 1-infected at enrollment. Group II children (n = 512) were enrolled prenatally or before 28 days postpartum and subsequently subdivided into group IIa (n = 86), children identified as HIV- 1-infected; and group IIb (n = 426), those who were HIV-1-uninfected. CRC were defined as parenchymal consolidations or nodular disease lasting 3 months or more or increased bronchovascular markings or reticular densities lasting 6 months or more. Morbidity was assessed by CD4 counts, viral load, the presence of low oxygen saturation, wheezing, tachypnea, crackles, and clubbing. RESULTS. The cumulative incidence of chronic radiographic lung changes in HIV-1-infected children was 32.8% by 4 years old, with increased bronchovascular markings or reticular densities being most common. Chronic changes were associated with lower CD4 cell counts and higher viral loads. Resolution of these chronic changes was associated with decreasing CD4 cell counts but not with lower rates of clinical findings, viral load, or difference in survival. CONCLUSION. With increased survival, CRC are becoming more common. The resolution of these changes may indicate immunologic deterioration rather than clinical improvement.

Original languageEnglish
Pages (from-to)1553-1558
Number of pages6
JournalAmerican Journal of Roentgenology
Volume176
Issue number6
StatePublished - Jun 18 2001
Externally publishedYes

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HIV Infections
HIV-1
Lung
CD4 Lymphocyte Count
Viral Load
Respiratory Sounds
Tachypnea
Incidence
Postpartum Period
Thorax
Mothers
Oxygen
Morbidity

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Norton, K. I., Kattan, M., Rao, J. S., Cleveland, R., Trautwein, L., Mellins, R. B., ... Platzker, A. C. G. (2001). Chronic radiographic lung changes in children with vertically transmitted HIV-1 infection. American Journal of Roentgenology, 176(6), 1553-1558.

Chronic radiographic lung changes in children with vertically transmitted HIV-1 infection. / Norton, K. I.; Kattan, M.; Rao, Jonnagadda S; Cleveland, R.; Trautwein, L.; Mellins, R. B.; Berdon, W.; Boechat, M. I.; Wood, B.; Meziane, M.; Platzker, A. C G.

In: American Journal of Roentgenology, Vol. 176, No. 6, 18.06.2001, p. 1553-1558.

Research output: Contribution to journalArticle

Norton, KI, Kattan, M, Rao, JS, Cleveland, R, Trautwein, L, Mellins, RB, Berdon, W, Boechat, MI, Wood, B, Meziane, M & Platzker, ACG 2001, 'Chronic radiographic lung changes in children with vertically transmitted HIV-1 infection', American Journal of Roentgenology, vol. 176, no. 6, pp. 1553-1558.
Norton KI, Kattan M, Rao JS, Cleveland R, Trautwein L, Mellins RB et al. Chronic radiographic lung changes in children with vertically transmitted HIV-1 infection. American Journal of Roentgenology. 2001 Jun 18;176(6):1553-1558.
Norton, K. I. ; Kattan, M. ; Rao, Jonnagadda S ; Cleveland, R. ; Trautwein, L. ; Mellins, R. B. ; Berdon, W. ; Boechat, M. I. ; Wood, B. ; Meziane, M. ; Platzker, A. C G. / Chronic radiographic lung changes in children with vertically transmitted HIV-1 infection. In: American Journal of Roentgenology. 2001 ; Vol. 176, No. 6. pp. 1553-1558.
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abstract = "OBJECTIVE. We prospectively studied children with and without maternally transmitted HIV-1 infection born to mothers infected with HIV-1 to determine the incidence of chronic radiographic lung changes (CRC) and to correlate these changes with clinical assessments. SUBJECTS AND METHODS. Between 1990 and 1997, we scored 3050 chest radiographs using a standardized form. Group I children (n = 201) were HIV- 1-infected at enrollment. Group II children (n = 512) were enrolled prenatally or before 28 days postpartum and subsequently subdivided into group IIa (n = 86), children identified as HIV- 1-infected; and group IIb (n = 426), those who were HIV-1-uninfected. CRC were defined as parenchymal consolidations or nodular disease lasting 3 months or more or increased bronchovascular markings or reticular densities lasting 6 months or more. Morbidity was assessed by CD4 counts, viral load, the presence of low oxygen saturation, wheezing, tachypnea, crackles, and clubbing. RESULTS. The cumulative incidence of chronic radiographic lung changes in HIV-1-infected children was 32.8{\%} by 4 years old, with increased bronchovascular markings or reticular densities being most common. Chronic changes were associated with lower CD4 cell counts and higher viral loads. Resolution of these chronic changes was associated with decreasing CD4 cell counts but not with lower rates of clinical findings, viral load, or difference in survival. CONCLUSION. With increased survival, CRC are becoming more common. The resolution of these changes may indicate immunologic deterioration rather than clinical improvement.",
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AU - Rao, Jonnagadda S

AU - Cleveland, R.

AU - Trautwein, L.

AU - Mellins, R. B.

AU - Berdon, W.

AU - Boechat, M. I.

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N2 - OBJECTIVE. We prospectively studied children with and without maternally transmitted HIV-1 infection born to mothers infected with HIV-1 to determine the incidence of chronic radiographic lung changes (CRC) and to correlate these changes with clinical assessments. SUBJECTS AND METHODS. Between 1990 and 1997, we scored 3050 chest radiographs using a standardized form. Group I children (n = 201) were HIV- 1-infected at enrollment. Group II children (n = 512) were enrolled prenatally or before 28 days postpartum and subsequently subdivided into group IIa (n = 86), children identified as HIV- 1-infected; and group IIb (n = 426), those who were HIV-1-uninfected. CRC were defined as parenchymal consolidations or nodular disease lasting 3 months or more or increased bronchovascular markings or reticular densities lasting 6 months or more. Morbidity was assessed by CD4 counts, viral load, the presence of low oxygen saturation, wheezing, tachypnea, crackles, and clubbing. RESULTS. The cumulative incidence of chronic radiographic lung changes in HIV-1-infected children was 32.8% by 4 years old, with increased bronchovascular markings or reticular densities being most common. Chronic changes were associated with lower CD4 cell counts and higher viral loads. Resolution of these chronic changes was associated with decreasing CD4 cell counts but not with lower rates of clinical findings, viral load, or difference in survival. CONCLUSION. With increased survival, CRC are becoming more common. The resolution of these changes may indicate immunologic deterioration rather than clinical improvement.

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