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HIV infection is associated with reduced pulmonary diffusing capacity.
- Author(s): Crothers, Kristina
- McGinnis, Kathleen
- Kleerup, Eric
- Wongtrakool, Cherry
- Hoo, Guy S
- Kim, Joon
- Sharafkhaneh, Amir
- Huang, Laurence
- Luo, Zhaoyu
- Thompson, Bruce
- Diaz, Philip
- Kirk, Gregory D
- Rom, William
- Detels, Roger
- Kingsley, Lawrence
- Morris, Alison
- et al.
Published Web Locationhttp://ovidsp.tx.ovid.com/sp-3.23.0a/ovidweb.cgi?WebLinkFrameset=1&S=GHOOFPFOODDDILPGNCHKFHLBMIBEAA00&returnUrl=ovidweb.cgi?&Full+Text=L%257cS.sh.22.23%257c0%257c00126334-201311010-00007&S=GHOOFPFOODDDILPGNCHKFHLBMIBEAA00&directlink=http://ovidsp.tx.ovid.com/ovftpdfs/FPDDNCLBFHPGOD00/fs047/ovft/live/gv024/00126334/00126334-201311010-00007.pdf&filename=HIV+Infection+Is+Associated+With+Reduced+Pulmonary+Diffusing+Capacity.&pdf_key=FPDDNCLBFHPGOD00&pdf_index=/fs047/ovft/live/gv024/00126334/00126334
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IntroductionPrior studies comparing abnormalities in pulmonary function between HIV-infected and HIV-uninfected persons in the current era are limited.
ObjectivesTo determine the pattern and severity of impairment in pulmonary function in HIV-infected compared with HIV-uninfected individuals.
MethodsCross-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.
ResultsMost 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.
ConclusionsHIV 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.
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