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HIV-related bronchiectasis in children: an emerging spectre in high tuberculosis burden areas

R Masekela1, R Anderson, T Moodley

  • 1Department of Paediatrics and Child Health, Division of Paediatric Pulmonology, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa. refiloe.masekela@up.ac.za

The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
|January 13, 2012
PubMed

Insights

Children with HIV-related bronchiectasis face significant risks and morbidity, often diagnosed after age six. Their immune systems remain active despite immunosuppression, indicating complex disease mechanisms.

Area of Science:

  • Pediatric Infectious Diseases
  • Pulmonology
  • Immunology

Background:

  • Children with Human Immunodeficiency Virus (HIV) have an eleven-fold increased risk of acute lower respiratory tract infections.
  • This heightened risk can lead to airway destruction and bronchiectasis in HIV-infected children.

Purpose of the Study:

  • To investigate predisposing factors for bronchiectasis development in children within a developing country context.
  • To understand the clinical characteristics and immunological profile of pediatric HIV-associated bronchiectasis.

Main Methods:

  • Enrolled children aged 6-14 years with HIV-related bronchiectasis.
  • Collected data on demographics, sputum for pathogens (bacteriology, virology, tuberculosis), cytokines, and performed spirometry.
  • Assessed HIV staging, immunoglobulins, specific IgE levels for allergens, and serum cytokines.

Main Results:

  • Haemophilus influenzae and parainfluenzae were the predominant organisms in sputum.
  • Median forced expiratory volume in 1 second was 53%, indicating significant airflow limitation.
  • Interleukin-8 was the predominant cytokine; elevated IgE levels were not clearly linked to atopy, and environmental tobacco smoke exposure showed no correlation with CD4 count.

Conclusions:

  • Pediatric HIV-related bronchiectasis is typically diagnosed after age six and is associated with substantial morbidity.
  • Despite HIV-induced immunosuppression, immune stimulation mechanisms appear to remain functional in these children.
Abstract

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