ASSOCIATION BETWEEN FINGER CLUBBING AND CHRONIC LUNG DISEASE IN HIV INFECTED CHILDREN AT KENYATTA NATIONAL HOSPITAL

East Afr Med J. 2013 Nov;90(11):342-9.

Abstract

Background: Finger clubbing in HIV infected children is associated with pulmonary diseases. Respiratory diseases cause great morbidity and mortality in HIV infected children.

Objective: To determine association between finger clubbing and chronic lung diseases in HIV infected children and their clinical correlates (in terms of WHO clinical staging, CD4 counts/percentage, anti-retroviral therapy duration and pulmonary hypertension).

Design: Hospital based case control study.

Setting: The Kenyatta National Hospital (KNH) comprehensive care clinic (CCC) for HIV infected children and Paediatric General Wards.

Subjects: The study population comprised of HIV infected children and adolescents aged eighteen years and below.

Results: Chronic lung disease was more common among finger clubbed (55%) than non finger clubbed patients (16.7%). Finger clubbed patients had higher risk of hypoxemia (46.7%), pulmonary hypertension (46.7%) and advanced disease in WHO stage III/IV (91.7%) compared to non-finger clubbed patients. Finger clubbed patients had lower CD4 cells count and percentage (median 369 cells, 13%) compared to non-clubbed patients (median 861 cells, 28%). Duration of ART use was shorter in finger clubbed patients (median 5.5 months) compared to non-finger clubbed patients (median 40 months).

Conclusion: Presence of finger clubbing in HIV infected children was associated with chronic lung disease, advanced WHO stage, lower CD4 counts/ percentage, shorter duration of ART use and higher likelihood of developing pulmonary hypertension.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anti-HIV Agents / therapeutic use
  • CD4 Lymphocyte Count
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Chronic Disease
  • HIV Infections / complications*
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy
  • Hospitals, Public
  • Humans
  • Infant
  • Kenya
  • Lung Diseases / complications*
  • Osteoarthropathy, Secondary Hypertrophic / complications*

Substances

  • Anti-HIV Agents