Am. J. Respir. Crit. Care Med.,
Volume 163, Number 4, March 2001, 865-873
Forced Expiratory Flow in Uninfected Infants and
Children Born to HIV-infected Mothers
ANDREW A.
COLIN,
J.
SUNIL RAO,
XIN C.
CHEN,
JANICE M.
HUNTER,
JOHN
HANRAHAN,
PETER
HIATT,
MEYER
KATTAN,
ANASTASSIOS
KOUMBOURLIS,
ROBERT B.
MELLINS,
HANNAH H.
PEAVY,
ARNOLD
PLATZKER,
ANDREW
TING,
SUZANNE
STEINBACH,
MARY ELLEN B.
WOHL, for the Pediatric Pulmonary and
Cardiovascular Complications of Vertically Transmitted Human Immunodeficiency Virus Study Group,
National
Heart,
Lung,
and
Blood
Institute
Division of Pulmonary Medicine, Children's Hospital, Department of Pediatrics/Harvard Medical School, Boston, Massachusetts; Department of
Biostatistics and Epidemiology, Cleveland Clinic Foundation, Cleveland, Ohio; Channing Laboratories, Boston, Massachusetts; Clinical Care Center,
Baylor College of Medicine, Texas Children's Hospital, Houston, Texas; Pediatric Pulmonary and Critical Care Division, Mount Sinai School of
Medicine, New York, New York; Department of Pediatrics, Pediatric Pulmonology, Presbyterian Hospital/Columbia University School of
Medicine, New York, New York; Division of Lung Diseases, National Heart, Lung, and Blood Institute, Bethesda, Maryland; Division of Pediatric
Pulmonology, Children's Hospital, University of Southern California/UCLA, Los Angeles, California; Department of Pediatric Pulmonology,
Boston Medical Center/Boston University, Boston, Massachusetts; and Department of Epidemiology and Biostatistics, Case Western
Reserve University, Cleveland, Ohio
The Pediatric Pulmonary and Cardiovascular Complications of Vertically Transmitted HIV (P2C2 HIV) Study is a multicenter study examining pulmonary and cardiac outcomes in offspring of HIV-infected
mothers. This portion of the P2C2 study tests the hypothesis that
infants exposed to, but uninfected by, maternal HIV have normal
maximal expiratory flow at functional residual capacity (V'max,FRC).
We obtained 500 measurements of V'max,FRC by rapid thoracic
compression in 285 children ages 6-30 mo in five U.S. centers. The
data were compared with those from a healthy cohort of children
described elsewhere. V'max,FRC rose with height in a linear relationship. The slope of the regression line in the exposed infants
did not differ statistically from the slope in the comparison group,
but the intercept was about 20% lower (p < 0.001). Height and
weight were comparable in the two cohorts, and the differences
between intercepts persisted after adjusting for birth weight and
gestational age. However, maternal HIV infection cannot be assumed to be the cause as the cohorts may have differed in other
variables, such as socioeconomic status and frequency of maternal
smoking and drug use. Also, measurements varied substantially
within and between our five centers, probably in part because of
different racial and ethnic distributions. In summary, maternal HIV
infection probably has only a modest effect, if any, on maximal expiratory flow at functional residual capacity in uninfected infants.
