Source: Annual Congress 2006 - Pneumonia and other invasive pulmonary infections in children
Disease area: Paediatric lung diseases

Abstract

Nitric oxide (NO) is a component of the host defence against infections. Normal fractional exhaled NO (FE_NO) and low nasal NO (nNO) have been demonstrated in HIV adults. FE_NO and nNO have never been measured in children with HIV infection. We measured FE_NO and nNO (ppb; NIOX, Aerocrine) in 30 children (19 females; median age: 10.7 yrs, range, 5.8-16 yrs) with perinatal HIV infection (median age at diagnosis: 1.5 yrs, range, 0.5-10 yrs). According to CDC criteria, 36.7% of patients were classified as class A, 43.3% as class B and 20% as class C. FVC and FEV1 (% pred), HIV mRNA (copies/ml) and CD4 absolute cells were measured. Recurrent rhinosinusitis (defined as 3 or more episodes of acute rhinosinusitis/year) or recurrent pneumonia (defined as at least 2 episodes in 1 year or > 3 at any time) were reported. Results are presented as mean ± SEM. FE_NO was 10.8 ppb ± 1.3 (values in healthy children according to Buchvald, 2005: 9.7 ppb). nNO was 161.2 ppb ± 26.3 (values in healthy children according to Struben, 2005: 449 ppb). FVC and FEV1 were 116. ± 3.9 and 114 ± 3.3 % pred, respectively. HIV RNA concentration and number of CD4 were 17063.67 ± 9256 copies/ml and 834.90 ± 61.6 cells/mm³, respectively. Recurrent rhinosinusitis or pneumonia were found in 24 (80% of the total) and in 9 of 30 cases (30% of the total), respectively. Age appeared significantly related to FE_NO (r= 0.4; p= 0.03), and not to nNO (r= 0.08; p= 0.7). FE_NO and nNO were not related to CDC class, HIV RNA concentration or CD4 cells. nNO was significantly related to recurrent rhinosinusitis (r= 0.5; p= 0.02). We speculate that low nNO may contribute to the decreased resistance to upper airway infections in children with HIV infection.

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F. Santamaria, S. De Stefano, E. Bruzzese, A. Detoraki, S. Montella, F. Barbarano, A. Guarino (Naples, Italy). Nasal and exhaled nitric oxide in children and adolescents with HIV-1 infection. Eur Respir J 2006; 28: Suppl. 50, 1787

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