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J Acquir Immune Defic Syndr. 2018 Dec 1;79(4):501-509. doi: 10.1097/QAI.0000000000001840.

Factors Associated With Progression of Lung Function Abnormalities in HIV-Infected Individuals.

Author information

1
Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
2
Clinical Pharmacy, Epidemiology, Biostatistics and Medicine, University of California, San Francisco, CA.
3
Department of Medicine, University of California, Los Angeles, CA.

Abstract

BACKGROUND:

HIV is an independent risk factor for chronic obstructive pulmonary disease; however, baseline risk factors for lung function decline remain largely unknown in this population.

METHODS:

HIV-infected participants in the Pittsburgh Lung HIV Cohort with at least 3 pulmonary function measurements between 2007 and 2016 were included. Pulmonary function testing including postbronchodilator (BD) spirometry and diffusion capacity for carbon monoxide (DLco) was performed every 18 months. We used a mixed-effect linear model to evaluate factors associated with pulmonary function testing and DLco decline and logistic regression models to evaluate factors associated with rapid FEV1 decline (defined as >80 mL per year) and any DLco decline.

RESULTS:

Two hundred eighty-five HIV-infected participants were included. Median baseline CD4 cell count was 521 cells per micro liter, 61.9% had an undetectable HIV viral load at baseline, and 78.5% were receiving ART. Approximately 20% of participants met Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria for a diagnosis of chronic obstructive pulmonary disease at baseline. Older age and baseline GOLD stage 1 compared with stage 0 were associated with faster decline in post-BD FEV1%, whereas female sex was associated with slower decline. Similarly, female sex was associated with slower decline in DLco%. HIV-related factors including CD4 cell count, viral load, and ART use were not significantly associated with pulmonary function decline.

CONCLUSIONS:

Older age, male sex, and higher baseline GOLD stage were associated with more rapid post-BD FEV1% decline in HIV-infected individuals.

PMID:
30142142
PMCID:
PMC6203646
[Available on 2019-12-01]
DOI:
10.1097/QAI.0000000000001840

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