Introduction : In adults chronically infected with HIV, there is an increased prevalence of impaired respiratory function, with a greater occurrence of COPD ( Chronic obstructive pulmonary disease) than in the uninfected population. In children, data from the literature show a higher prevalence of atopy. Additionally, adolescents treated since birth for HIV infection in utero often exhibit bronchial hyperreactivity or peripheral bronchial obstruction, indicating chronic local inflammation. This study aims to evaluate the value of early detection of peripheral obstruction in HIV-infected adolescents, initiating early treatment and preventing long-term respiratory function impairment in adulthood. Methods : This prospective monocentric study included patients aged 11 to 25. Participants underwent forced oscillometry, conventional respiratory functional exploration, and completed a respiratory quality of life questionnaire. The primary endpoint was the parameter R5Hz Results : 21 teenagers were included in our study. Regarding the primary endpoint, one patient out of 13 (7.6%) showed an increase in R5Hz. Three (23%) exhibited abnormal resistance exploration. Regardless, three patients met the criteria for bronchial hyperreactivity. Concerning the questionnaire, three patients, despite having no respiratory function impairment, reported a decreased quality of life associated with breathing. Conclusion : There is probably approximately 15% of children infected with HIV at birth in France experiencing chronic lung inflammation. More accurate detection through oscillometry would enable precise identification of these children and offer them targeted treatment. This approach could not only improve their quality of life but also help preventing progressive decline in respiratory function and the development of chronic bronchopathy in adulthood.

Background. Whether small airway dysfunction (SAD), which is prevalent in asthma, helps to characterize wheezing phenotypes is undetermined. The objective was to assess whether SAD parameters obtained from impedance measurement and asthma probability are linked. Methods. One hundred and thirty-nine preschool children (mean age 4.7 years, 68% boys) suffering from recurrent wheeze underwent impulse oscillometry that allowed calculating peripheral resistance and compliance of the respiratory system (markers of SAD) using the extended RIC model (central and peripheral Resistance, Inertance and peripheral Compliance of the respiratory system). Children were classified using the probability-based approach of GINA guidelines (few, some, most having asthma). A principal component analysis (PCA) that determined the dimensions of wheezing disease evaluated the links between SAD and asthma probability. Results. Forty-seven children belonged to the few, 28 to the some and 64 to the most having asthma groups. Whereas their anthropometrics and measured parameters were similar, the most having asthma group exhibited the lowest mean value of airway inertance after bronchodilator probably due to airway inhomogeneities. PCA characterized nine independent dimensions including a peripheral resistance (constituted by baseline peripheral resistance, AX, R5-20Hz, X5Hz), a central resistance (baseline central resistance, R20Hz) and an airway size dimension (post-bronchodilator inertance and central resistance). PCA showed that the SAD markers were independent from clinical dimensions (control and asthma probability were two other dimensions) and did not help to define wheezing phenotypes. Conclusions. Lung function parameters obtained from impulse oscillometry and asthma probability were belonging to independent dimensions of the wheezing disease.