{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T01:40:39Z","timestamp":1777513239702,"version":"3.51.4"},"reference-count":35,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2023,7,21]],"date-time":"2023-07-21T00:00:00Z","timestamp":1689897600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health & Human Development","doi-asserted-by":"crossref","award":["#1R01HD083042"],"award-info":[{"award-number":["#1R01HD083042"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Collaborative Initiative for Pediatric HIV Education and Research","award":["#158-INN"],"award-info":[{"award-number":["#158-INN"]}]},{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"crossref","award":["TMA2019SFP-2836 TB lung-FACT2"],"award-info":[{"award-number":["TMA2019SFP-2836 TB lung-FACT2"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"crossref"}]},{"name":"University of Cape Town Clinical Trials Unit","award":["#UM1AI069519"],"award-info":[{"award-number":["#UM1AI069519"]}]},{"name":"Fogarty International Center of the National Institutes of Health","award":["1D43TW010937-01A1"],"award-info":[{"award-number":["1D43TW010937-01A1"]}]},{"name":"Fogarty International Center of the National Institutes of Health","award":["K43TW011028"],"award-info":[{"award-number":["K43TW011028"]}]},{"name":"Fogarty International Center of the National Institutes of Health","award":["R24-TW007988"],"award-info":[{"award-number":["R24-TW007988"]}]},{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","award":["#47884"],"award-info":[{"award-number":["#47884"]}],"id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Research Foundation of South Africa","award":["121426"],"award-info":[{"award-number":["121426"]}]},{"name":"South African National Research Foundation","award":["#29276"],"award-info":[{"award-number":["#29276"]}]},{"name":"University of California, Centre for AIDS Research","award":["#P30 AI036214-16; Subaward: S10304442 and PO# S900"],"award-info":[{"award-number":["#P30 AI036214-16; Subaward: S10304442 and PO# S900"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Thorax"],"accepted":{"date-parts":[[2023,6,26]]},"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Lung disease remains a frequent complication in children with perinatal HIV infection (CHIV) and exposure without infection (CHEU), resulting in diminished lung function. In CHIV, early antiretroviral therapy (ART) initiation improves survival and extrapulmonary outcomes. However, it is unknown if there is benefit to lung function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cohorts of CHIV (ART initiated at median 4.0 months), CHEU and HIV-unexposed children (CHU) prospectively performed pulmonary function testing (PFT) consisting of spirometry, plethysmography and diffusing capacity from 2013 to 2020. We determined lung function trajectories for PFT outcomes comparing CHIV to CHU and CHEU to CHU, using linear mixed effects models with multiple imputation. Potential confounders included sex, age, height, weight, body mass index z-score, urine cotinine and Tanner stage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>328 participants (122 CHIV, 126 CHEU, 80 CHU) performed PFT (ages 6.6\u201315.6 years). Spirometry (forced expiratory volume in 1 s, FEV1, forced vital capacity (FVC), FEV1\/FVC) outcomes were similar between groups. In plethysmography, the mean residual volume (RV) z-score was 17% greater in CHIV than CHU (95%\u2009CI 1% to 33%, p=0.042). There was no difference in total lung capacity (TLC) or RV\/TLC z-scores between groups. Diffusing capacity for carbon monoxide was similar in all groups, while alveolar volume (VA) differed between HIV groups by sex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study indicates that early ART initiation can mitigate the loss of lung function in CHIV with lasting benefit through childhood; however, there remains concern of small airway disease. CHEU does not appear to disrupt childhood lung function trajectory.<\/jats:p><\/jats:sec>","DOI":"10.1136\/thorax-2023-220197","type":"journal-article","created":{"date-parts":[[2023,7,21]],"date-time":"2023-07-21T17:24:22Z","timestamp":1689960262000},"page":"1233-1239","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Lung function tracking in children with perinatally acquired HIV following early antiretroviral therapy 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