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. 2010 Sep 15;182(6):790-6.
doi: 10.1164/rccm.200912-1858OC. Epub 2010 Jun 3.

Pulmonary function abnormalities in HIV-infected patients during the current antiretroviral therapy era

Matthew R Gingo  1 , M Patricia George, Cathy J Kessinger, Lorrie Lucht, Barbara Rissler, Renee Weinman, William A Slivka, Deborah K McMahon, Sally E Wenzel, Frank C Sciurba, Alison Morris
Affiliations

Pulmonary function abnormalities in HIV-infected patients during the current antiretroviral therapy era

Matthew R Gingo et al. Am J Respir Crit Care Med. .

Abstract

Rationale: Before the introduction of combination antiretroviral (ARV) therapy, patients infected with HIV had an increased prevalence of respiratory symptoms and lung function abnormalities. The prevalence and exact phenotype of pulmonary abnormalities in the current era are unknown. In addition, these abnormalities may be underdiagnosed.

Objectives: Our objective was to determine the current burden of respiratory symptoms, pulmonary function abnormalities, and associated risk factors in individuals infected with HIV.

Methods: Cross-sectional analysis of 167 participants infected with HIV who underwent pulmonary function testing.

Measurements and main results: Respiratory symptoms were present in 47.3% of participants and associated with intravenous drug use (odds ratio [OR] 3.64; 95% confidence interval [CI], 1.32-10.046; P = 0.01). Only 15% had previous pulmonary testing. Pulmonary function abnormalities were common with 64.1% of participants having diffusion impairment and 21% having irreversible airway obstruction. Diffusion impairment was independently associated with ever smoking (OR 2.46; 95% CI, 1.16-5.21; P = 0.02) and Pneumocystis pneumonia prophylaxis (OR 2.94; 95% CI, 1.10-7.86; P = 0.01), whereas irreversible airway obstruction was independently associated with pack-years smoked (OR 1.03 per pack-year; 95% CI, 1.01-1.05; P < 0.01), intravenous drug use (OR 2.87; 95% CI, 1.15-7.09; P = 0.02), and the use of ARV therapy (OR 6.22; 95% CI, 1.19-32.43; P = 0.03).

Conclusions: Respiratory symptoms and pulmonary function abnormalities remain common in individuals infected with HIV. Smoking and intravenous drug use are still important risk factors for pulmonary abnormalities, but ARV may be a novel risk factor for irreversible airway obstruction. Obstructive lung disease is likely underdiagnosed in this population.

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Figures

Figure 1.
Figure 1.
(A) Frequency of respiratory symptoms. (B) Frequency of having any symptoms or using inhaler medication for all participants (All), those who have ever smoked (Ever smokers), and those who have never smoked (Never smokers). Whiskers represent the 95% confidence interval.
Figure 2.
Figure 2.
Distribution of results of pulmonary function testing. Boxplots show the median and interquartile range. (A) Post-bronchodilator FEV1 % predicted. (B) Post-bronchodilator FVC % predicted. (C) Post-bronchodilator FEV1/FVC. (D) Corrected DlCO % predicted. All = all participants; DlCO = diffusing capacity for carbon monoxide; ESm = ever smokers, those who have ever smoked; NSm = never smokers, those who have never smoked.
Figure 3.
Figure 3.
Frequency of pulmonary function phenotypes of all participants (All), those who have ever smoked (Ever smokers), and those who have never smoked (Never Smokers). Whiskers represent the 95% confidence interval. BD = bronchodilator; DlCO = diffusing capacity for carbon monoxide.
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References

    1. Palella FJ Jr, Delaney KM, Moorman AC, Loveless MO, Fuhrer J, Satten GA, Aschman DJ, Holmberg SD. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. N Engl J Med 1998;338:853–860. - PubMed
    1. Wallace JM, Hansen NI, Lavange L, Glassroth J, Browdy BL, Rosen MJ, Kvale PA, Mangura BT, Reichman LB, Hopewell PC. Respiratory disease trends in the pulmonary complications of HIV infection study cohort. Pulmonary Complications of HIV Infection Study Group. Am J Respir Crit Care Med 1997;155:72–80. - PubMed
    1. Moore RD, Chaisson RE. Natural history of HIV infection in the era of combination antiretroviral therapy. AIDS 1999;13:1933–1942. - PubMed
    1. Palella FJ Jr, Baker RK, Moorman AC, Chmiel JS, Wood KC, Brooks JT, Holmberg SD. Mortality in the highly active antiretroviral therapy era: changing causes of death and disease in the HIV outpatient study. J Acquir Immune Defic Syndr 2006;43:27–34. - PubMed
    1. Morris AM, Huang L, Bacchetti P, Turner J, Hopewell PC, Wallace JM, Kvale PA, Rosen MJ, Glassroth J, Reichman LB, et al. Permanent declines in pulmonary function following pneumonia in human immunodeficiency virus-infected persons. The Pulmonary Complications of HIV Infection Study Group. Am J Respir Crit Care Med 2000;162:612–616. - PubMed

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