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J Acquir Immune Defic Syndr. 2016 Apr 1;71(4):420-7. doi: 10.1097/QAI.0000000000000894.

Risk Factors Associated With Quantitative Evidence of Lung Emphysema and Fibrosis in an HIV-Infected Cohort.

Author information

1
*Image Research Division, Department of Radiology, University of Pittsburgh, Pittsburgh, PA;†Division of Pulmonary and Critical Care, Department of Internal Medicine, University of Washington, Seattle, WA;‡Division of Pulmonary and Critical Care Medicine and HIV/AIDS Division, Department of Medicine, San Francisco General Hospital, University of California, San Francisco, CA;§Division of Thoracic Imaging, Department of Radiology, Ohio State University, Columbus, OH;‖Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA;¶Clinical Trials & Surveys Corp., Baltimore, MD;#Division of Pulmonary Sciences & Critical Care Medicine, University of Colorado, Aurora, CO;**Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD;††Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, New York University School of Medicine, New York, NY; and‡‡Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Internal Medicine, Ohio State University, Columbus, OH.

Abstract

INTRODUCTION:

The disease spectrum for HIV-infected individuals has shifted toward comorbid non-AIDS conditions including chronic lung disease, but quantitative image analysis of lung disease has not been performed.

OBJECTIVES:

To quantify the prevalence of structural changes of the lung indicating emphysema or fibrosis on radiographic examination.

METHODS:

A cross-sectional analysis of 510 HIV-infected participants in the multicenter Lung-HIV study was performed. Data collected included demographics, biological markers of HIV, pulmonary function testing, and chest computed tomographic examinations. Emphysema and fibrosis-like changes were quantified on computed tomographic images based on threshold approaches.

RESULTS:

In our cohort, 69% was on antiretroviral therapy, 13% had a current CD4 cell count less than 200 cells per microliter, 39% had an HIV viral load greater than 500 copies per milliliter, and 25% had at least a trace level of emphysema (defined as >2.5% of voxels <-950HU). Trace emphysema was significantly correlated with age, smoking, and pulmonary function. Neither current CD4 cell count nor HIV viral load was significantly correlated with emphysema. Fibrosis-like changes were detected in 29% of the participants and were significantly correlated with HIV viral load (Pearson correlation coefficient = 0.210; P < 0.05); current CD4 cell count was not associated with fibrosis. In multivariable analyses including age, race, and smoking status, HIV viral load remained significantly correlated with fibrosis-like changes (coefficient = 0.107; P = 0.03).

CONCLUSIONS:

A higher HIV viral load was significantly associated with fibrosis-like changes, possibly indicating early interstitial lung disease, but emphysematous changes were not related to current CD4 cell count or HIV viral load.

PMID:
26914911
PMCID:
PMC4770858
DOI:
10.1097/QAI.0000000000000894
[Indexed for MEDLINE]
Free PMC Article

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