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ObjectiveTo describe the features of HIV-associated chronic lung disease (CLD) in older children and adolescents living with HIV and to examine the clinical factors associated with CLD. This is a post hoc analysis of baseline data from the BREATHE clinical trial (, NCT02426112).MethodsChildren and adolescents aged 6-19 years were screened for CLD (defined as a FEV1 z-score ResultsOf the 1585 participants screened, 419 (32%) had a FEV1 z-score 0 as controls [median age 15.6 years (IQR 12.1-18.2); 62.2% female]. Among cases, current respiratory symptoms including cough and shortness of breath were reported infrequently (9.3% and 1.8%, respectively). However, 152 (43.8%) of cases had a respiratory rate above the 90th centile for their age. Wasting and taking second-line ART were independently associated with CLD.ConclusionsThe presence of CLD indicates the need to address additional treatment support for youth living with HIV, alongside ART provision, to ensure a healthier adulthood.

Original publication




Journal article


Tropical medicine & international health : TM & IH

Publication Date





590 - 599


Biomedical Research and Training Institute, Harare, Zimbabwe.


BREATHE Clinical Trial Team, Humans, HIV-1, HIV Infections, Lung Diseases, Case-Control Studies, Adolescent, Child, Survivors, Child Health Services, Malawi, Zimbabwe, Female, Male, Young Adult, Surveys and Questionnaires