Table 1.

Study, year	Location, participant N	Characteristics of HIV-infected adolescents	Respiratory symptoms/signs	Abnormal spirometry
Ferrand, et al. [8*], 2012	Harare, Zimbabwe N=116	Mean age: 14 ± 2.6 years 43% male Mean age at HIV diagnosis: 12 years Perinatally-acquired HIV: 100% 69% on ART for median duration of 2 years	66% chronic cough 21% reduced exercise tolerance 10% digital clubbing 13% SaO2 <92% at rest 29% hypoxia after sub-maximal exercise 28% respiratory rate >25 bpm	OBSTRUCTED: 52/116 (45%) based on FEV1 <80% predicted - Predicted values based on age-, sex-, and height-adjusted standards in healthy Malawian schoolchildren
McHugh, et al. [10*], 2016	Harare, Zimbabwe N=385	Median age: 11 [6–15] years 48% male Median age at HIV diagnosis: 11 years Perinatally-acquired HIV: 95% All ART-naïve	54% cough >1 month 16% MRC dyspnoea score ≥2 14% SaO2 <88% 10% with SaO2 <88% after sub-maximal exercise	OBSTRUCTED: 23/238 (10%) had FEV1 and FEV1/FVC <1.64 SD below mean - 3 had bronchodilator reversibility RESTRICTED: 43/238 (18%) had FVC <1.64 SD below mean and normal FEV1/FVC
Mwalukomo, et al. [11*], 2016	Blantyre, Malawi N=160	Median age: 11 [10–12] years 50% male Median age at HIV diagnosis: 8 years Perinatally-acquired HIV: 56% 74% on ART for median duration of 4 years	38% cough 34% moderate/severe dyspnoea 22% digital clubbing 21% SaO2 <92% 36% respiratory rate >24 bpm	OBSTRUCTED: 26/145 (18%) had FEV1 and FEV1/FVC <LLN using GLI 2012 equations RESTRICTED: 29/145 (20%) had FVC <LLN and FEV1/FVC ≥LLN using GLI 2012 equations 15 of 55 with abnormal spirometry had bronchodilator reversibility, but overall median increase in FEV1 only 3%
Attia, et al. [12*], 2015	Nairobi, Kenya N=55	Median age: 13 [11–14] years 54% male Age at HIV diagnosis: Not reported Perinatally-acquired HIV: 100% 95% on ART	60% cough 51% sputum production 31% wheeze (self-reported) 11% SaO2 ≤92% 38% SaO2 ≤92% after sub-maximal exercise	OBSTRUCTED: - 10/55 (18%) pre-bronchodilator FEV1/FVC <0.7 - 8/55 (15%) post-bronchodilator FEV1/FVC <0.7
Rylance S, et al. [14*], 2016	Harare, Zimbabwe N=385 ART-naïve and 202 ART-treated	Median age: 11 [9–13] years 45% male Median age at HIV diagnosis: 11 years among ART-naïve vs 6 years among ART-treated Perinatally-acquired HIV: 100% Median duration of ART use: 6 years among ART-treated	ART-naïve compared to ART-treated: Daily cough in 53 vs 15% Dyspnoea in 12 vs 15% Resting hypoxia in 14 vs 1% Greater exercise limitation (walked 460 vs 770 m on shuttle walk testing)	ART-naïve compared to ART-treated: Abnormal spirometry in 26 vs 24% OBSTRUCTED: 24/262 (9%) vs 7/177 (4%) RESTRICTED: 43/262 (16%) vs 36/177 (20%) - based on reduced FVC
Rylance J, et al. [15*], 2016	Harare, Zimbabwe N=202 HIV-infected and 150 age-matched HIV-uninfected	Median age: 11 [9–13] years 51% male Median age at HIV diagnosis: 6 years Perinatally-acquired HIV: 99.5% All HIV-infected receiving ART; ART initiated at a median age of 6 years	HIV-infected compared to HIV-uninfected: Daily cough in 15 vs 1% Dyspnoea in 15 vs 0% Sputum production in 10 vs 1% Respiratory rate >25 bpm in 14 vs 6% Greater exercise limitation (walked 771 vs 889 m on shuttle walk testing)	HIV-infected compared to HIV-uninfected: OBSTRUCTED: 4/177 (4%) vs 1/130 (1%) RESTRICTED: 36/177 (20%) vs 14/130 (11%) - based on reduced FVC 11/31 (36%) vs 2/6 (33%) had bronchodilator reversibility (only those with abnormal spirometry were tested)
Githinji, et al. [18**], 2016	Cape Town, South Africa N=515 HIV-infected and 110 age-, sex-, ethnically-matched HIV-uninfected controls	Mean age: 12 ± 1.6 years 52% male Age at HIV diagnosis: Not reported Perinatally-acquired HIV: 100% Median duration of ART use: 8 years	Not reported	HIV-infected compared to HIV-uninfected: OBSTRUCTED: 44/515 (9%) among HIV-infected - FEV1: 1.60 L in HIV-infected vs 1.86 L in HIV-uninfected RESTRICTED: 75/515 (15%) among HIV-infected based on measured lung volumes - FVC: 1.80 L in HIV-infected vs 2.00 L in HIV-uninfected 75/515 (15%) vs 9/110 (8%) had bronchodilator reversibility ➔Overall, HIV-infected had reduced lung function (i.e., lung volumes, airflow, compliance) compared to HIV-uninfected
Shearer, et al. [19*], 2015	United States (multiple sites) N=216 HIV-infected and 151 HIV-exposed uninfected	Median age: 17 [14–19] years 42% male Age at HIV diagnosis: Not reported Perinatally-acquired HIV: 100% ART use: Not reported	Not reported	HIV-infected compared to HIV-uninfected: OBSTRUCTED: 42/188 (22%) vs 28/132 (21%) had FEV1 <80% or FEV1/FVC <0.8 RESTRICTED: 18/188 (10%) vs 17/132 (13%) had FVC <80% and FEV1/FVC ≥0.8 17/188 (9%) vs 21/132 (17%) had bronchodilator reversibility -Predicted values calculated based on normative equations generated using values from healthy children in NHANES III