Association Between Finger Clubbing and Chronic Lung Disease in HIV Infected Children at Kenyatta National Hospital
AbstractBackground: 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 369cells, 13%) compared to non-clubbed patients (median 861cells, 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.