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Non-infective pulmonary disease in HIV-positive children

Salomine Theron1, Savvas Andronikou, Reena George

  • 1Department of Radiology, Tygerberg Academic Hospital, University of Stellenbosch, Faculty of Health Sciences, Tygerberg, Cape Town, South Africa.

Pediatric Radiology
|March 21, 2009
PubMed

Insights

Pediatric pulmonary disease is a major concern in children with human immunodeficiency virus (HIV), especially in sub-Saharan Africa. This review highlights imaging findings of chronic, non-infective lung conditions in these children.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Radiology

Background:

  • Over 90% of pediatric human immunodeficiency virus (HIV) infections occur in developing nations, with sub-Saharan Africa being highly affected.
  • Pulmonary disease is the leading cause of morbidity and mortality in children with acquired immunodeficiency syndrome (AIDS), causing death in 50% of cases.
  • Improved antiretroviral therapy leads to longer survival, altering thoracic manifestations and introducing new complications in HIV-infected children.

Purpose of the Study:

  • To review the imaging findings of non-infective chronic pulmonary disease in children with HIV.
  • To understand the evolving spectrum of thoracic complications in pediatric HIV.
  • To provide a resource for radiologists and clinicians managing pediatric HIV lung disease.

Main Methods:

  • Literature review focusing on imaging findings of non-infective chronic pulmonary disease in pediatric HIV.
  • Analysis of reported chronic changes on chest radiographs in HIV-positive children.
  • Discussion of common non-infective pulmonary conditions including lymphocytic interstitial pneumonitis and malignancies.

Main Results:

  • Chronic changes on chest radiographs are observed in 33% of HIV-positive children by age 4.
  • Lymphocytic interstitial pneumonitis accounts for 30-40% of pulmonary disease in this population.
  • HIV-positive children have an increased incidence of pulmonary malignancies like lymphoma and Kaposi sarcoma, alongside immune reconstitution inflammatory syndrome.

Conclusions:

  • Non-infective chronic pulmonary diseases represent a significant burden in pediatric HIV.
  • Radiographic and CT findings are crucial for diagnosing and managing these complex conditions.
  • Ongoing research and updated imaging protocols are necessary to address the changing landscape of pediatric HIV-related lung disease.

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