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Pediatric Radiology

, Volume 39, Issue 6, pp 555–564 | Cite as

Non-infective pulmonary disease in HIV-positive children

  • Salomine Theron
  • Savvas AndronikouEmail author
  • Reena George
  • Jaco du Plessis
  • Pierre Goussard
  • Murray Hayes
  • Ayanda Mapukata
  • Robert Gie
Minisymposium

Abstract

It is estimated that over 90% of children infected with human immunodeficiency virus (HIV) live in the developing world and particularly in sub-Saharan Africa. Pulmonary disease is the most common clinical feature of acquired immunodeficiency syndrome (AIDS) in infants and children causing the most morbidity and mortality, and is the primary cause of death in 50% of cases. Children with lung disease are surviving progressively longer because of earlier diagnosis and antiretroviral treatment and, therefore, thoracic manifestations have continued to change and unexpected complications are being encountered. It has been reported that 33% of HIV-positive children have chronic changes on chest radiographs by the age of 4 years. Lymphocytic interstitial pneumonitis is common in the paediatric HIV population and is responsible for 30–40% of pulmonary disease. HIV-positive children also have a higher incidence of pulmonary malignancies, including lymphoma and pulmonary Kaposi sarcoma. Immune reconstitution inflammatory syndrome is seen after highly active antiretroviral treatment. Complications of pulmonary infections, aspiration and rarely interstitial pneumonitis are also seen. This review focuses on the imaging findings of non-infective chronic pulmonary disease.

Keywords

Lung HIV Lymphocytic interstitial pneumonitis Immune reconstitution inflammatory syndrome Lymphoma Kaposi sarcoma Radiology Children 

References

  1. 1.
    Joint United Nations Programme on HIV/AIDS. AIDS epidemic update: December 2006. http://www.unaids.org/en/KnowledgeCentre/HIVData/EpiUpdate/EpiUpdArchive/2006/
  2. 2.
    Graham SM, Coulter JB, Gilks CF (2001) Pulmonary disease in HIV-infected African children. Int J Tuberc Lung Dis 5:12–23PubMedGoogle Scholar
  3. 3.
    Marolda J, Pace B, Bonforte RJ et al (1991) Pulmonary manifestations of HIV infection in children. Pediatr Pulmonol 10:231–235PubMedCrossRefGoogle Scholar
  4. 4.
    Zar HJ (2008) Chronic lung disease in human immunodeficiency virus (HIV) infected children. Pediatr Pulmonol 43:1–10PubMedCrossRefGoogle Scholar
  5. 5.
    Zalar AE, Olmos MA, Piskorz EL et al (2003) Esophageal motility disorders in HIV patients. Dig Dis Sci 48:962–967PubMedCrossRefGoogle Scholar
  6. 6.
    Halvorsen RA Jr, Moelleken SM, Kearney AT (2003) Videofluoroscopic evaluation of HIV/AIDS patients with swallowing dysfunction. Abdom Imaging 28:244–247PubMedCrossRefGoogle Scholar
  7. 7.
    Norton KI, Kattan M, Rao JS et al (2001) Chronic radiographic lung changes in children with vertically transmitted HIV1-infection. AJR 176:1553–1558PubMedGoogle Scholar
  8. 8.
    Berdon WE, Mellins RB, Abramson SJ et al (1993) Pediatric HIV infection in its second decade: the changing pattern of lung involvement. Radiol Clin North Am 31:453–463PubMedGoogle Scholar
  9. 9.
    Graham SM, Gibb DM (2002) HIV disease and respiratory infection in children. Br Med Bull 61:133–150PubMedCrossRefGoogle Scholar
  10. 10.
    Jeanes AC, Owens CM (2002) Imaging of HIV disease in children. Imaging 14:8–23Google Scholar
  11. 11.
    Marks MJ, Haney PJ, McDermott MP et al (1996) Thoracic disease in children with AIDS. Radiographics 16:1349–1362PubMedGoogle Scholar
  12. 12.
    Marquis JR, Berman CZ, DiCarlo F et al (1993) Radiographic patterns of PLH/LIP in HIV-positive children. Pediatr Radiol 23:328–330PubMedCrossRefGoogle Scholar
  13. 13.
    Ambrosino MM, Roche KJ, Genieser NB et al (1995) Application of thin-section low-dose chest CT (TSCT) in the management of pediatric AIDS. Pediatr Radiol 25:393–400PubMedCrossRefGoogle Scholar
  14. 14.
    Rabie H, Marais BJ, van Toorn R et al (2007) Important HIV-associated conditions in HIV-infected infants and children. SA Fam Pract 49:19–23Google Scholar
  15. 15.
    Sheikh S, Madiraju K, Steiner P et al (1997) Bronchiectasis in pediatric AIDS. Chest 112:1202–1207PubMedCrossRefGoogle Scholar
  16. 16.
    Evans JA, Gibb DM, Holland FJ et al (1997) Malignancies in UK children with HIV infection acquired from mother to child transmission. Arch Dis Child 76:330–333PubMedCrossRefGoogle Scholar
  17. 17.
    Biggar RJ, Frisch M, Goedert JJ (2000) Risk of cancer in children with AIDS. AIDS-Cancer Match Registry Study Group. JAMA 284:205–209PubMedCrossRefGoogle Scholar
  18. 18.
    Siskin GP, Haller JO, Miller S et al (1995) AIDS-related lymphoma: radiologic features in pediatric patients. Radiology 196:63–66PubMedGoogle Scholar
  19. 19.
    Miller R (1996) HIV-associated respiratory diseases. Lancet 348:307–312PubMedCrossRefGoogle Scholar
  20. 20.
    Fishman EK, Kuhlman JE, Jones RJ (1991) CT of lymphoma: spectrum of disease. Radiographics 11:647–669PubMedGoogle Scholar
  21. 21.
    Theron S, Andronikou S, Du Plessis J et al (2007) Pulmonary Kaposi sarcoma in six children. Pediatr Radiol 37:1224–1229PubMedCrossRefGoogle Scholar
  22. 22.
    Zieller J, Katongole-Mbibbe E (1996) Kaposi sarcoma in childhood: analysis of 100 cases from Uganda and relationship to HIV infection. Int J Cancer 65:200–203CrossRefGoogle Scholar
  23. 23.
    Rajeswaran G, Becker JL, Michailidis C et al (2006) The radiology of IRIS (immune reconstitution inflammatory syndrome) in patients with mycobacterial tuberculosis and HIV co-infection: appearances in 11 patients. Clin Radiol 61:833–843PubMedCrossRefGoogle Scholar
  24. 24.
    Boesch RP, Daines C, Willging JP et al (2006) Advances in the diagnosis and management of chronic pulmonary aspiration in children. Eur Respir J 28:847–861PubMedCrossRefGoogle Scholar
  25. 25.
    Franquet T (2004) Respiratory infection in the AIDS and immunocompromised patient. Eur Radiol 14:E21–33PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Salomine Theron
    • 1
  • Savvas Andronikou
    • 1
    Email author
  • Reena George
    • 1
  • Jaco du Plessis
    • 1
  • Pierre Goussard
    • 2
  • Murray Hayes
    • 1
  • Ayanda Mapukata
    • 1
  • Robert Gie
    • 2
  1. 1.Department of Radiology, Tygerberg Academic HospitalUniversity of StellenboschCape TownSouth Africa
  2. 2.Department of Child Health, Tygerberg Academic HospitalUniversity of StellenboschCape TownSouth Africa

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