Robin J Green
Department of Paediatrics and Child Health, University of Pretoria, South Africa
Title: New Insights into the Bugs in the Airway of HIV-infected Children with Lung Disease
Biography
Biography: Robin J Green
Abstract
Pulmonary diseases and syndromes occur in human immunodeficiency virus (HIV)-infected children and they often differ from children not co-infected by the HI virus.Pneumocystis jiroveci pneumonia (PCP) is a common opportunistic LRTI in HIV-infected infants, early in life and presents as acute severe pneumonia. The presence of PCP is known to be commonly associated with Cytomegalovirus co-infection and CMV is often responsible for mortality. Bacterial and viral co-infection occurs but does not impact outcome. The cytokine results suggest that the major cytokine associated with severe hypoxic pneumonia in very young, HIV-infected, infants is IP-10. There is now clear evidence that bronchiolitis is not a common condition in HIV-infected infants. New evidence is emerging that Human Rhinovirus is associated with both bronchiolitis and pneumonia in both HIV-infected and –non-infected children. With regard to the sputum cytokines identified in children with an acute lower respiratory tract infection, IL-13, IL-4, IL-5, TNF-α, IFN-α, IFN-γ, and MIP-1α are significantly lower in HIV-infected cases, whilst IP-10 and MIG are significantly higher in HIV-infected cases.Chronic lung disease, especially bronchiectasis, is often a sequelae in HIV-infected children. H. influenzae and -parainfluenzae are the predominant organisms cultured in children with HIV-related bronchiectasis and now shown to be the dominant microbiome in such individuals. Il-8 is the cytokine which dominates in children with HIV-associated bronchiectasis.
