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The aim of this study was to investigate the prevalence and associations of cardiopulmonary dysfunction in adolescents with perinatally acquired HIV on ART.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>For this cross\u2010sectional analysis, 515 perinatally HIV\u2010positive adolescents ages 9 to 14\u00a0years on ART for at least six months, and a comparator group of 110 age\u2010matched HIV\u2010uninfected adolescents were tested between August 2013 and April 2015 using echocardiography, six\u2010minute walk test (6MWT) and spirometry. Those with either abnormal spirometry or abnormal 6MWT and any right or left systolic or diastolic dysfunction or abnormal mean pulmonary arterial pressure were considered as having impaired cardiopulmonary function. Logistic regression was used to investigate determinants of impaired cardiopulmonary function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 474 adolescents with perinatally acquired HIV (mean [SD] age, 12 [1.6] years; median [IQR] ART duration, 7 [4.6 to 9.3] years; median [IQR] CD4 count, 712 [571 to 959] cell\/mm<jats:sup>3<\/jats:sup>) and 109 HIV\u2010uninfected adolescents mean (SD) age 11.8 (1.8) years, had successful cardiac and lung function testing. Impaired cardiopulmonary function was detected in 13% of adolescents with perinatally acquired HIV and 8% of HIV\u2010uninfected adolescents, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.136. Among adolescents with perinatally acquired HIV, those with low tricuspid annular plane systolic excursion (TAPSE) had significantly lower mean FEV<jats:sub>1<\/jats:sub>, 1.5\u00a0L versus 1.6\u00a0L, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.011. Height (OR 0.7, 95%CI 0.5 to 0.9), body mass index (OR 0.7, 95%CI 0.5 to 0.9) and past pulmonary tuberculosis (OR 2.3, 95%CI 1.2 to 4.4) were significantly associated with a low cardiopulmonary function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite being on ART, cardiopulmonary dysfunction occurs in an appreciable proportion of perinatally HIV\u2010infected adolescents but no significant difference to uninfected controls. This finding requires further exploration. Factors associated with dysfunction may be amenable to public health interventions to reduce cardiopulmonary disease in this population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25340","type":"journal-article","created":{"date-parts":[[2019,7,10]],"date-time":"2019-07-10T14:58:54Z","timestamp":1562770734000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Cardiopulmonary dysfunction in perinatally HIV\u2010infected South African adolescents on antiretroviral therapy: baseline findings from the Cape Town Adolescent Antiretroviral Cohort"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0480-0868","authenticated-orcid":false,"given":"Leah N","family":"Githinji","sequence":"first","affiliation":[{"name":"South Africa MRC unit on Child and Adolescent Health Department of Paediatrics and Child Health Red Cross War Memorial Children's Hospital University of Cape Town Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sana","family":"Mahtab","sequence":"additional","affiliation":[{"name":"South Africa MRC unit on Child and Adolescent Health Department of Paediatrics and Child Health Red Cross War Memorial Children's Hospital University of Cape Town Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liesl","family":"Z\u00fchlke","sequence":"additional","affiliation":[{"name":"Division of Paediatric Cardiology Department of Paediatrics and Child Health Red Cross War Memorial Children's Hospital University of Cape Town Cape Town South Africa"},{"name":"Division of Cardiology Department of Medicine Groote Schuur Hospital Faculty of Health Sciences University of Cape Town Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Lawrenson","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health Stellenbosch University Matieland South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Landon","family":"Myer","sequence":"additional","affiliation":[{"name":"Division of Epidemiology &amp; 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