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J Infect Dis. 2019 Apr 8;219(8):1274-1284. doi: 10.1093/infdis/jiy653.

Reduced Forced Vital Capacity Among Human Immunodeficiency Virus-Infected Middle-Aged Individuals.

Author information

1
Amsterdam UMC, University of Amsterdam, Departments of Global Health and Internal Medicine, Amsterdam Infection and Immunity Institute and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
2
Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
3
HIV Monitoring Foundation, Amsterdam, The Netherlands.
4
Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
5
Division of Pulmonary and Critical Care Medicine, University of North Carolina, Chapel Hill.
6
Amsterdam UMC, University of Amsterdam, Department of Pulmonary Medicine, The Netherlands.
7
Department of Infectious Diseases, Public Health Service of Amsterdam, The Netherlands.

Abstract

BACKGROUND:

Pulmonary function impairments are more common among people living with HIV (PLWH), as are contributing risk behaviors. To understand the effects of human immunodeficiency virus (HIV) infection independent of risk behaviors, pulmonary function was evaluated in lifestyle-comparable HIV-infected and -uninfected AGEhIV cohort participants.

METHODS:

Prevalence of obstructive lung disease in 544 HIV-infected and 529 HIV-uninfected participants was determined using spirometry. Logistic regression was used to assess HIV as a determinant of obstructive lung disease. Additional explanatory models were constructed to explain observed differences.

RESULTS:

The unadjusted obstructive lung disease prevalence was similar in HIV-infected (23.0%) and -uninfected (23.4%) participants. Multivariable logistic regression analysis showed an effect modification whereby obstructive lung disease prevalence among persons with limited smoking experience was notably lower among HIV-infected compared with HIV-uninfected participants. This resulted from a lower forced vital capacity (FVC) in HIV-infected participants but similar 1-second forced expiratory volume (FEV1), especially in those with limited smoking experience.

CONCLUSIONS:

The lower FVC in HIV-infected participants could indicate HIV-related restrictive or fibrotic pulmonary changes. Factors that decrease the FVC could obscure emphysematous changes in the lungs of PLWH when using the FEV1/FVC ratio as single diagnostic measure.

CLINICAL TRIALS REGISTRATION:

NCT01466582.

KEYWORDS:

HIV infection; chronic obstructive; pulmonary disease; pulmonary fibrosis; respiratory function tests; spirometry

PMID:
30418599
DOI:
10.1093/infdis/jiy653

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