English
norskBlar i forfatter "McHugh, Grace"
Viser treff 1-13 av 13
-
Azithromycin versus placebo for the treatment of HIV-associated chronic lung disease in children and adolescents (BREATHE trial): study protocol for a randomised controlled trial
(Journal article; Tidsskriftartikkel; Peer reviewed, 2017-12-28)Background<br> Human immunodeficiency virus (HIV)-related chronic lung disease (CLD) among children is associated with substantial morbidity, despite antiretroviral therapy. This may be a consequence of repeated respiratory tract infections and/or dysregulated immune activation that accompanies HIV infection. Macrolides have anti-inflammatory and antimicrobial properties, and we hypothesised that ... -
Composition of gut microbiota of children and adolescents with perinatal HIV infection taking antiretroviral therapy in Zimbabwe
(Journal article; Tidsskriftartikkel; Peer reviewed, 2019-09-24)<p><i>Background - </i>Human immunodeficiency virus (HIV) infection causes impairment of the gastrointestinal barrier, with substantial depletion of CD4<sup>+</sup> T cells in the gut. Antiretroviral therapy (ART) restores CD4<sup>+</sup> counts and may have beneficial effects on gut microbiota in adults. Little is known about effect of long-term ART on gut microbiome in HIV-infected children. We ... -
Cytomegalovirus-SpecificImmunoglobulin G is associated with chronic lung disease in children and adolescents from sub-Saharan Africa with perinatal HIV infection
(Journal article; Tidsskriftartikkel; Peer reviewed, 2020-11-26)In a cross-sectional study of 296 children and adolescents from Zimbabwe living with perinatal human immunodeficiency virus, individuals with the top tertile of cytomegalovirus-specific immunoglobulin G titer had an increased odds of chronic lung disease (odds ratio, 3.33; 95% confidence interval, 1.37–8.85; P = .010). -
Echocardiographic reference ranges in older children and adolescents in sub-Saharan Africa
(Journal article; Tidsskriftartikkel; Peer reviewed, 2017-06-30)Background: Echocardiographic reference ranges are important to identify abnormalities of cardiac dimensions. Reference ranges for children in sub-Saharan Africa have not been established. The aim of this study was to establish echocardiographic z-score references for Black children in sub-Saharan Africa.<p> <p>Methods: 282 healthy subjects aged 6–16 years (143 [51%] males) with no known history ... -
“The effect of 48-weeks azithromycin therapy on levels of soluble biomarkers associated with HIV-associated chronic lung disease”
(Journal article; Tidsskriftartikkel; Peer reviewed, 2023-01-20)Objectives - HIV-associated immune activation contributes to chronic lung disease (CLD) in children and adolescents living with HIV. Azithromycin has immunomodulatory and anti-microbial properties that may be useful for treating HIV-associated CLD (HCLD). This study describes the effect of azithromycin on expression of plasma soluble biomarkers in children and adolescents with HCLD.<p> <p>Methods ... -
The effect of azithromycin for management of HIV-associated chronic lung disease on right heart function: Results from the BREATHE trial
(Journal article; Tidsskriftartikkel; Peer reviewed, 2021-11-20)Background - Right heart abnormalities and pulmonary hypertension (PH) may be secondary to chronic lung disease. Chronic lung disease is common in children with HIV. In the BREATHE trial (Trial registration: NCT02426112), azithromycin (AZM) reduced the risk of acute respiratory exacerbations in children aged 6–19 years with HIV-associated chronic lung disease (HCLD) taking antiretroviral therapy. ... -
Effect of azithromycin on incidence of acute respiratory exacerbations in children with HIV taking antiretroviral therapy and co-morbid chronic lung disease: a secondary analysis of the BREATHE trial
(Journal article; Tidsskriftartikkel; Peer reviewed, 2021-11-13)Background - In the BREATHE trial weekly azithromycin decreased the rate of acute respiratory exacerbations (AREs) compared to placebo among children and adolescents with HIV-associated chronic lung disease (CLD) taking antiretroviral therapy (ART). The aim of this analysis was to identify risk factors associated with AREs and mediators of the effect of azithromycin on AREs.<p> <p>Methods - The ... -
Effect of Once-Weekly Azithromycin vs Placebo in Children With HIV-Associated Chronic Lung Disease: The BREATHE Randomized Clinical Trial
(Journal article; Tidsskriftartikkel; Peer reviewed, 2020-12-17)<i>Importance</i> - HIV-associated chronic lung disease (HCLD) in children is associated with small airways disease, is common despite antiretroviral therapy (ART), and is associated with substantial morbidity. Azithromycin has antibiotic and immunomodulatory activity and may be effective in treating HCLD through reducing respiratory tract infections and inflammation.<p> <p><i>Objective</i> - ... -
High prevalence of echocardiographic abnormalities in older HIV-infected children taking antiretroviral therapy
(Journal article; Tidsskriftartikkel; Peer reviewed, 2018-11-28)Background: Antiretroviral therapy (ART) has decreased mortality so that increasing numbers of children with HIV are reaching adolescence. However, longstanding HIV infection and/or its treatment in children is associated with noninfectious complications including cardiac disease. We investigated the prevalence, spectrum and risk factors for echocardiographic abnormalities among children established ... -
History of tuberculosis is associated with lower exhaled nitric oxide levels in HIV-infected children
(Journal article; Tidsskriftartikkel; Peer reviewed, 2019-09-01)<p><i>Objective - </i>HIV disrupts host defense mechanisms and maintains chronic inflammation in the lung. Nitric oxide is a marker of lung inflammation and can be measured in the exhaled air. We investigated the relationship between exhaled nitric oxide (eNO), HIV status and airway abnormalities in perinatally HIV-infected children aged 6–19 years. <p><i>Design - </i>A cross-sectional study. <p ... -
The impact of long-term azithromycin on antibiotic resistance in HIV-associated chronic lung disease
(Journal article; Tidsskriftartikkel; Peer reviewed, 2022-02-07)Selection for resistance to azithromycin (AZM) and other antibiotics such as tetracyclines and lincosamides remains a concern with long-term AZM use for treatment of chronic lung diseases (CLD). We investigated the impact of 48 weeks of AZM on the carriage and antibiotic resistance of common respiratory bacteria among children with HIV-associated CLD. Nasopharyngeal (NP) swabs and sputa were ... -
Prevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung disease
(Journal article; Tidsskriftartikkel; Peer reviewed, 2021-02-25)<b>Background</b> HIV-associated chronic lung disease (CLD) is common among children living with HIV (CLWH) in sub-Saharan Africa, including those on antiretroviral therapy (ART). However, the pathogenesis of CLD and its possible association with microbial determinants remain poorly understood. We investigated the prevalence, and antibiotic susceptibility of <i>Streptococcus pneumoniae </i>(SP), ... -
Sputum bacterial load and bacterial composition correlate with lung function and are altered by long-term azithromycin treatment in children with HIV-associated chronic lung disease
(Journal article; Tidsskriftartikkel; Peer reviewed, 2023-02-20)Background - Long-term azithromycin (AZM) treatment reduces the frequency of acute respiratory exacerbation in children and adolescents with HIV-associated chronic lung disease (HCLD). However, the impact of this treatment on the respiratory bacteriome is unknown.<p> <p>Method - African children with HCLD (defined as forced expiratory volume in 1 s z-score (FEV1z) less than − 1.0 with no ...
