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PLoS One. 2019 Jan 15;14(1):e0210573. doi: 10.1371/journal.pone.0210573. eCollection 2019.

The association between HIV infection and pulmonary function in a rural African population.

Author information

1
Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
2
Department of Internal Medicine & Infectious Diseases, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
3
Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand Johannesburg, Johannesburg, South Africa.
4
Ndlovu Care Group, Groblersdal, South Africa.
5
Julius Clinical Research, Academic Contract Research Organization, Zeist, the Netherlands.
6
Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Abstract

OBJECTIVES:

HIV infection has been associated with an impaired lung function in high-income countries, but the association between HIV infection and pulmonary function in Sub-Saharan Africa remains unclear. This study aims to investigate the relation between HIV infection and pulmonary function in a rural African population.

METHODS:

A cross-sectional study was conducted among HIV-positive and HIV-negative adults in a rural area in South Africa, as part of the Ndlovu Cohort Study. A respiratory questionnaire and post-bronchodilator spirometry were performed. Multivariable regression analysis was used to investigate whether HIV was independently associated with a decrease in post-bronchodilator FEV1/FVC ratio considering age, sex, body mass index, respiratory risk factors and a history of a pulmonary infection (tuberculosis (TB) or a pneumonia). Possible mediation by a history of pulmonary infection was tested by removing this variable from the final model.

RESULTS:

Two hundred and one consecutive participants were enrolled in the study in 2016, 84 (41.8%) were HIV-positive (82.1% on ART). The median age was 38 (IQR 29-51) years. Following multivariable analysis HIV was not significantly associated to a decline in post-bronchodilator FEV1/FVC ratio (β -0.017, p 0.18). However, upon removal of a history of a pulmonary infection from the final model HIV was significantly related to post-bronchodilator FEV1/FVC ratio, β -0.026, p 0.03.

CONCLUSIONS:

Pulmonary function is affected by HIV infection which most likely results from co-infection with TB or other pneumonia. Further research should focus on the influence of a pulmonary infection, most notably TB, on pulmonary function, especially as the incidence of TB is high in HIV infection.

Conflict of interest statement

A.G. Vos received a once-off grand of 1,700 euros from Boehringer Ingelheim, The Netherlands, to support the acquisition of disposables for the spirometry measurement. This funding does not alter our adherence to PLOS ONE policies on sharing data and materials.

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