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Observational Study
. 2020 Jul 1;34(8):1227-1235.
doi: 10.1097/QAD.0000000000002526.

Lung function in men with and without HIV

Ken M Kunisaki  1   2 , Mehdi Nouraie  3 , Robert L Jensen  4 , Dong Chang  5 , Gypsyamber D'Souza  6 , Meghan E Fitzpatrick  3 , Meredith C McCormack  7 , Valentina Stosor  8 , Alison Morris  3
Affiliations
Observational Study

Lung function in men with and without HIV

Ken M Kunisaki et al. AIDS. .

Abstract

Objectives: Initial studies suggest HIV-positive persons may be at increased risk for chronic lung diseases such as chronic obstructive pulmonary disease, but have commonly relied on single-center designs, lacked HIV-negative controls, or assessed lung function with only spirometry. We tested differences in spirometry and single-breath diffusing capacity for carbon monoxide (DLCO) in persons with and without HIV.

Design: Cross-sectional, observational study.

Methods: Participants were enrolled from the Multicenter AIDS Cohort Study, a longitudinal cohort study of men who have sex with men (both HIV-positive and HIV-negative) at four sites in the United States. Standardized spirometry and DLCO testing were performed in all eligible, consenting participants at routine study visits. We tested associations between HIV status and spirometry and DLCO results, using linear and logistic regression.

Results: Among 1067 men, median age was 57 years, prevalence of current marijuana (30%), and cigarette (24%) use was high, and another 45% were former cigarette smokers. Median forced expiratory volume in 1 s was 97% of predicted normal and DLCO was 85% of predicted normal. HIV-positive persons demonstrated no statistical difference in forced expiratory volume in 1 s compared with HIV-negative persons, but had worse DLCO (adjusted difference -2.6% of predicted; 95% confidence interval: -4.7 to -0.6%) and a higher risk of DLCO impairment (odds ratio for DLCO < 60% of predicted 2.97; 95% confidence interval: 1.36-6.47). Lower DLCO was associated with lower nadir CD4 cell counts.

Conclusion: HIV-positive men are at increased risk of abnormal gas exchange, indicated by low DLCO, compared with men without HIV.

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Conflict of interest statement

Conflicts of interest

All authors have received grant support from NIH for the work presented here. K.M.K. has received consultancy fees from GlaxoSmithKline and Nuvaira, Inc. outside the work presented here; has received contracted clinical trial support from AstraZeneca and Sanofi outside the work presented here. R.J. has received consultancy fees from ndd Medical Technologies. D.C., G.D., M.E.F., V.S., and A.M.: nothing to declare. M.C.M. has received consultancy fees from GlaxoSmithKline and royalties from UpToDate outside the work presented here.

Figures

Fig. 1.
Fig. 1.. Study participant selection for the pulmonary function test substudy of the Multicenter AIDS Cohort Study.
Spirometry and diffusing capacity of the lung for carbon monoxide were performed at routine scheduled Multicenter AIDS Cohort Study visits at visit 67 or visit 68 which occurred between 1 April 2017 and 31 March 2018. Quality control was performed via central review of all spirometry tests, blinded to HIV status.
See this image and copyright information in PMC

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