Author(s): Crothers K, McGinnis K, Kleerup E, Wongtrakool C, Hoo GS,
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Abstract INTRODUCTION: Prior studies comparing abnormalities in pulmonary function between HIV-infected and HIV-uninfected persons in the current era are limited. OBJECTIVES: To determine the pattern and severity of impairment in pulmonary function in HIV-infected compared with HIV-uninfected individuals. METHODS: Cross-sectional analysis of 300 HIV-infected men and 289 HIV-uninfected men enrolled from 2009 to 2011 in 2 clinical centers of the Lung HIV Study. Participants completed pre- and postbronchodilator spirometry, diffusing capacity of the lung for carbon monoxide (DLCO) measurement, and standardized questionnaires. RESULTS: Most participants had normal airflow; 18\% of HIV-infected and 16\% of HIV-uninfected men had airflow obstruction. The mean percent predicted DLCO was 69\% in HIV-infected vs. 76\% in HIV-uninfected men (P < 0.001). A moderately to severely reduced DLCO of ≤60\% was observed in 30\% of HIV-infected compared with 18\% of HIV-uninfected men (P < 0.001), despite the fact that 89\% of those with HIV were on antiretroviral therapy. A reduced DLCO was significantly associated with HIV and CD4 cell count in linear regression adjusting for smoking and other confounders. The DLCO was lowest in HIV-infected men with CD4 cell counts <200 cells per microliter compared with those with CD4 cell counts ≥200 cells per microliter and to HIV-uninfected men. Respiratory symptoms of cough, phlegm and dyspnea were more prevalent in HIV-infected patients particularly those with abnormal pulmonary function compared with HIV-uninfected patients. CONCLUSIONS: HIV infection is an independent risk factor for reduced DLCO, particularly in individuals with a CD4 cell count below 200 cells per microliter. Abnormalities in pulmonary function among HIV-infected patients manifest clinically with increased respiratory symptoms. Mechanisms accounting for the reduced DLCO require further evaluation.
This article was published in J Acquir Immune Defic Syndr
and referenced in Journal of Infectious Diseases & Therapy