55 - Respiratory Disorders in Children and Adolescents Living With HIV

Abstract

Respiratory diseases cause major morbidity and mortality in children living with human immunodeficiency virus (HIV), in particular in sub-Saharan Africa. The spectrum of respiratory illness encompasses acute and chronic disease. Even with improved access to antiretroviral therapy (ART), acute pneumonia remains more common in children living with HIV, with pulmonary tuberculosis and pneumocystis pneumonia important causes of severe disease. With effective prevention of mother-to-child transmission, the majority of HIV-exposed infants are uninfected; however, these infants have a higher risk of respiratory infection compared with unexposed children in early life. Early use of ART in children with HIV is highly effective in reducing the incidence of infections and pulmonary morbidity and mortality. Preventive interventions, including immunization and use of long-term cotrimoxazole prophylaxis, reduce the incidence of specific respiratory infections and improve survival rates. In regard to long-term survival, chronic lung disease in adolescents living with perinatally acquired HIV is an important cause of morbidity, that can be ameliorated can be ameliorated by the use of ART and better prevention of lower respiratory tract infections and tuberculosis.