Risk Factors for Hypoxia and Tachypnea Among Adolescents With Vertically-acquired HIV in Nairobi

Engi F. Attia, Noel S. Weiss, Elizabeth Maleche Obimbo, Christine J. McGrath, Anthony Cagle, T. Eoin West, Neveen G. El Antouny, Mena Attwa, Kristina Crothers, Michael H. Chung

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Chronic lung diseases are increasingly recognized complications of vertically-acquired HIV among adolescents in sub-Saharan Africa and may manifest with hypoxia or tachypnea. We sought to determine the prevalence of and risk factors for hypoxia and tachypnea among adolescents with vertically-acquired HIV in Nairobi, Kenya. Methods: We performed a cross-sectional analysis of 258 adolescents with vertically-acquired HIV who were initiating care at the Coptic Hope Center for Infectious Diseases. Adolescents with documented pneumonia were excluded. Hypoxia was defined as resting oxygen saturation ≤92%, and tachypnea was based on the 99th percentile of age-appropriate respiratory rates. Logistic regression models adjusted for demographics, and HIV severity estimated odds ratios for risk of hypoxia and tachypnea associated with potential risk factors. Results: Overall, 11% of adolescents had hypoxia and 55% had tachypnea. Advanced HIV [adjusted odds ratio (aOR): 2.41] and low CD4 (aOR: 1.74) were associated with greater hypoxia risk, but confidence intervals (CIs) were wide and included the null (95% CI: 0.93-6.23 and 0.69-4.39, respectively). Low CD4 (aOR: 2.45, 95% CI: 1.39-4.32), current antiretroviral therapy use (aOR: 0.48, 95% CI: 0.27-0.86) and stunted growth (aOR: 3.46, 95% CI: 1.94-6.18) were associated with altered tachypnea risk. Conclusions: Hypoxia and tachypnea are common among adolescents with vertically-acquired HIV. There was a suggestion that advanced HIV and low CD4 were associated with greater hypoxia risk. Low CD4, lack of antiretroviral therapy use and stunted growth are risk factors for tachypnea. Our findings highlight the chronic lung disease burden in this population and may inform diagnostic algorithms.

Original languageEnglish (US)
Pages (from-to)e93-e97
JournalPediatric Infectious Disease Journal
Volume36
Issue number4
DOIs
StatePublished - Apr 1 2017

Fingerprint

Tachypnea
HIV
Odds Ratio
Confidence Intervals
Growth Disorders
Lung Diseases
Chronic Disease
Logistic Models
Hypoxia
Africa South of the Sahara
Kenya
Respiratory Rate
Communicable Diseases
Intercellular Signaling Peptides and Proteins
Pneumonia
Cross-Sectional Studies
Demography
Oxygen

Keywords

  • adolescents
  • chronic lung disease
  • hypoxia
  • tachypnea
  • vertically-acquired HIV

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Attia, E. F., Weiss, N. S., Maleche Obimbo, E., McGrath, C. J., Cagle, A., West, T. E., ... Chung, M. H. (2017). Risk Factors for Hypoxia and Tachypnea Among Adolescents With Vertically-acquired HIV in Nairobi. Pediatric Infectious Disease Journal, 36(4), e93-e97. https://doi.org/10.1097/INF.0000000000001453

Risk Factors for Hypoxia and Tachypnea Among Adolescents With Vertically-acquired HIV in Nairobi. / Attia, Engi F.; Weiss, Noel S.; Maleche Obimbo, Elizabeth; McGrath, Christine J.; Cagle, Anthony; West, T. Eoin; El Antouny, Neveen G.; Attwa, Mena; Crothers, Kristina; Chung, Michael H.

In: Pediatric Infectious Disease Journal, Vol. 36, No. 4, 01.04.2017, p. e93-e97.

Research output: Contribution to journalArticle

Attia, EF, Weiss, NS, Maleche Obimbo, E, McGrath, CJ, Cagle, A, West, TE, El Antouny, NG, Attwa, M, Crothers, K & Chung, MH 2017, 'Risk Factors for Hypoxia and Tachypnea Among Adolescents With Vertically-acquired HIV in Nairobi', Pediatric Infectious Disease Journal, vol. 36, no. 4, pp. e93-e97. https://doi.org/10.1097/INF.0000000000001453
Attia, Engi F. ; Weiss, Noel S. ; Maleche Obimbo, Elizabeth ; McGrath, Christine J. ; Cagle, Anthony ; West, T. Eoin ; El Antouny, Neveen G. ; Attwa, Mena ; Crothers, Kristina ; Chung, Michael H. / Risk Factors for Hypoxia and Tachypnea Among Adolescents With Vertically-acquired HIV in Nairobi. In: Pediatric Infectious Disease Journal. 2017 ; Vol. 36, No. 4. pp. e93-e97.
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abstract = "Background: Chronic lung diseases are increasingly recognized complications of vertically-acquired HIV among adolescents in sub-Saharan Africa and may manifest with hypoxia or tachypnea. We sought to determine the prevalence of and risk factors for hypoxia and tachypnea among adolescents with vertically-acquired HIV in Nairobi, Kenya. Methods: We performed a cross-sectional analysis of 258 adolescents with vertically-acquired HIV who were initiating care at the Coptic Hope Center for Infectious Diseases. Adolescents with documented pneumonia were excluded. Hypoxia was defined as resting oxygen saturation ≤92{\%}, and tachypnea was based on the 99th percentile of age-appropriate respiratory rates. Logistic regression models adjusted for demographics, and HIV severity estimated odds ratios for risk of hypoxia and tachypnea associated with potential risk factors. Results: Overall, 11{\%} of adolescents had hypoxia and 55{\%} had tachypnea. Advanced HIV [adjusted odds ratio (aOR): 2.41] and low CD4 (aOR: 1.74) were associated with greater hypoxia risk, but confidence intervals (CIs) were wide and included the null (95{\%} CI: 0.93-6.23 and 0.69-4.39, respectively). Low CD4 (aOR: 2.45, 95{\%} CI: 1.39-4.32), current antiretroviral therapy use (aOR: 0.48, 95{\%} CI: 0.27-0.86) and stunted growth (aOR: 3.46, 95{\%} CI: 1.94-6.18) were associated with altered tachypnea risk. Conclusions: Hypoxia and tachypnea are common among adolescents with vertically-acquired HIV. There was a suggestion that advanced HIV and low CD4 were associated with greater hypoxia risk. Low CD4, lack of antiretroviral therapy use and stunted growth are risk factors for tachypnea. Our findings highlight the chronic lung disease burden in this population and may inform diagnostic algorithms.",
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AU - Attia, Engi F.

AU - Weiss, Noel S.

AU - Maleche Obimbo, Elizabeth

AU - McGrath, Christine J.

AU - Cagle, Anthony

AU - West, T. Eoin

AU - El Antouny, Neveen G.

AU - Attwa, Mena

AU - Crothers, Kristina

AU - Chung, Michael H.

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N2 - Background: Chronic lung diseases are increasingly recognized complications of vertically-acquired HIV among adolescents in sub-Saharan Africa and may manifest with hypoxia or tachypnea. We sought to determine the prevalence of and risk factors for hypoxia and tachypnea among adolescents with vertically-acquired HIV in Nairobi, Kenya. Methods: We performed a cross-sectional analysis of 258 adolescents with vertically-acquired HIV who were initiating care at the Coptic Hope Center for Infectious Diseases. Adolescents with documented pneumonia were excluded. Hypoxia was defined as resting oxygen saturation ≤92%, and tachypnea was based on the 99th percentile of age-appropriate respiratory rates. Logistic regression models adjusted for demographics, and HIV severity estimated odds ratios for risk of hypoxia and tachypnea associated with potential risk factors. Results: Overall, 11% of adolescents had hypoxia and 55% had tachypnea. Advanced HIV [adjusted odds ratio (aOR): 2.41] and low CD4 (aOR: 1.74) were associated with greater hypoxia risk, but confidence intervals (CIs) were wide and included the null (95% CI: 0.93-6.23 and 0.69-4.39, respectively). Low CD4 (aOR: 2.45, 95% CI: 1.39-4.32), current antiretroviral therapy use (aOR: 0.48, 95% CI: 0.27-0.86) and stunted growth (aOR: 3.46, 95% CI: 1.94-6.18) were associated with altered tachypnea risk. Conclusions: Hypoxia and tachypnea are common among adolescents with vertically-acquired HIV. There was a suggestion that advanced HIV and low CD4 were associated with greater hypoxia risk. Low CD4, lack of antiretroviral therapy use and stunted growth are risk factors for tachypnea. Our findings highlight the chronic lung disease burden in this population and may inform diagnostic algorithms.

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