Subject(s)
AIDS-Related Opportunistic Infections/virology , HIV Infections/complications , Lung Diseases/virology , Lung Neoplasms/virology , Pulmonary Disease, Chronic Obstructive/virology , AIDS-Related Opportunistic Infections/epidemiology , Adult , Antiretroviral Therapy, Highly Active , Child , HIV Infections/drug therapy , HIV Infections/epidemiology , HIV Infections/immunology , Humans , Incidence , Lung Diseases/epidemiology , Lung Diseases, Fungal/epidemiology , Lung Diseases, Fungal/virology , Lung Neoplasms/epidemiology , Pneumonia, Bacterial/epidemiology , Pneumonia, Bacterial/virology , Pneumonia, Pneumocystis/epidemiology , Pneumonia, Pneumocystis/virology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Pulmonary Disease, Chronic Obstructive/epidemiology , Tuberculosis, Pulmonary/epidemiology , Tuberculosis, Pulmonary/virology , United States/epidemiologyABSTRACT
The Pediatric Pulmonary and Cardiovascular Complications of Vertically Transmitted HIV (P(2)C(2) HIV) Study is a multicenter study examining pulmonary and cardiac outcomes in offspring of HIV-infected mothers. This portion of the P(2)C(2) study tests the hypothesis that infants exposed to, but uninfected by, maternal HIV have normal maximal expiratory flow at functional residual capacity (V'max,(FRC)). We obtained 500 measurements of V'max,(FRC) by rapid thoracic compression in 285 children ages 6-30 mo in five U.S. centers. The data were compared with those from a healthy cohort of children described elsewhere. V'max,(FRC) rose with height in a linear relationship. The slope of the regression line in the exposed infants did not differ statistically from the slope in the comparison group, but the intercept was about 20% lower (p < 0.001). Height and weight were comparable in the two cohorts, and the differences between intercepts persisted after adjusting for birth weight and gestational age. However, maternal HIV infection cannot be assumed to be the cause as the cohorts may have differed in other variables, such as socioeconomic status and frequency of maternal smoking and drug use. Also, measurements varied substantially within and between our five centers, probably in part because of different racial and ethnic distributions. In summary, maternal HIV infection probably has only a modest effect, if any, on maximal expiratory flow at functional residual capacity in uninfected infants.
Subject(s)
Forced Expiratory Flow Rates , HIV Infections/congenital , HIV Infections/transmission , Infectious Disease Transmission, Vertical , Age Factors , Analysis of Variance , Case-Control Studies , Child, Preschool , Cohort Studies , Female , Humans , Infant , Linear Models , Male , Pregnancy , Probability , Reference Values , Respiratory Function Tests , Sensitivity and Specificity , Sex FactorsABSTRACT
PURPOSE: To determine the usefulness of technetium 99m diethyltriaminepentacetic acid (DTPA) radioaerosol inhalation-clearance scintigraphy for early detection of pulmonary complications of human immunodeficiency virus (HIV) disease in children. MATERIALS AND METHODS: A total of 301 studies were performed in 132 HIV-positive children (group 1; mean age, 46.6 months). In children born to HIV-positive mothers (group 2), 273 studies were performed in 160 children who eventually were proved to be HIV negative (mean age, 10.3 months), and 80 studies were performed in 47 HIV-positive children (mean age, 15.6 months). Radioaerosol studies were performed by using commercially available radioaerosol nebulizers. Pulmonary clearance half-time was measured by using conventional gamma camera computer systems. Radioaerosol results were correlated with indexes of pulmonary health and function. RESULTS: The HIV-negative, group 2 children had a mean radioaerosol clearance half-time (58.1 minutes; 162 studies in 108 children) similar to that reported in healthy adults. Group 1 children with pulmonary involvement exhibited a faster mean clearance half-time (28.6 minutes) than did children without evidence of pulmonary involvement from either group 1 or group 2 (P < .05). A faster pulmonary clearance rate did not simply reflect the presence of chest disease that also was detectable on radiographs (P = .3). CONCLUSION: Quantitative DTPA radioaerosol clearance studies may provide useful information about pulmonary involvement in selected children with HIV disease.
Subject(s)
HIV Infections/diagnostic imaging , Lung Diseases/diagnostic imaging , Radiopharmaceuticals , Technetium Tc 99m Pentetate , Administration, Inhalation , Adult , Aerosols , Child , Child, Preschool , Cohort Studies , Computer Systems , Female , Follow-Up Studies , Gamma Cameras , HIV Infections/transmission , HIV Seronegativity , HIV Seropositivity/diagnostic imaging , Half-Life , Humans , Infant , Infant, Newborn , Infectious Disease Transmission, Vertical , Least-Squares Analysis , Lung/diagnostic imaging , Nebulizers and Vaporizers , Proportional Hazards Models , Prospective Studies , Radionuclide Imaging , Radiopharmaceuticals/administration & dosage , Technetium Tc 99m Pentetate/administration & dosageSubject(s)
Lung Neoplasms/diagnosis , Lymphangioleiomyomatosis/diagnosis , Humans , Registries , United StatesSubject(s)
Lung Diseases, Obstructive/physiopathology , Nutritional Physiological Phenomena , Respiratory Physiological Phenomena , Animal Nutritional Physiological Phenomena , Animals , Connective Tissue/physiology , Disease Models, Animal , Extracellular Matrix/physiology , Female , Food Deprivation , Humans , Lung/growth & development , Lung/pathology , Muscles/physiology , Pregnancy , Prenatal Exposure Delayed Effects , Protein-Energy Malnutrition/complications , Protein-Energy Malnutrition/physiopathology , Vitamin B 6 Deficiency/complications , Vitamin B 6 Deficiency/physiopathologyABSTRACT
Single breath diffusing capacities for carbon monoxide (DLco) were measured in 12 normal supine subjects before and after ingestion of 15 to 30 ml of 95 percent ethanol (ETOH) to determine if alcohol could acutely change the DLco. Both DLco and specific DLco (DLco/alveolar volume) were significantly decreased 90 minutes after the ingestion of alcohol. This change may be due to a direct effect of alcohol on the alveolar capillary interface by possibly interfering with a carbon monoxide carrier molecule. Another plausible explanation for the reduced diffusing capacity after ingestion of alcohol may be redistribution of blood from the lung to the periphery secondary to the hemodynamic effects of alcohol.
