PMID- 28902919
OWN - NLM
STAT- MEDLINE
DCOM- 20171024
LR  - 20171024
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 9
DP  - 2017
TI  - Factors associated with pulmonary impairment in HIV-infected South African
      adults.
PG  - e0184530
LID - 10.1371/journal.pone.0184530 [doi]
AB  - BACKGROUND: HIV-infected individuals have increased risk of developing
      obstructive lung disease (OLD). Studies from developed countries report high
      viral load, low CD4 counts, and anti-retroviral therapy (ART) to be associated
      with OLD; but these findings may not be generalizable to populations in
      resource-limited settings. METHODS: We conducted a prospective cohort study of
      lung function in 730 HIV-infected black South African adults. Pre-bronchodilator 
      spirometry was performed at enrollment and repeated annually for three years.
      Logistic regression models were used to identify factors associated with OLD,
      defined as FEV1/FVC<0.70, at enrollment. Excess annual declines in FEV1 and FVC
      were modelled as the product-term of follow-up time and exposures using random
      effects regression. RESULTS: Median (IQR) age at enrollment was 36 (32-41) years,
      85% were female and 30% ever-smoked with a median (IQR) exposure of 3 (1-6)
      pack-years. Median (IQR) CD4 count and viral load at enrollment were 372
      (261-518) cells/mm3 and 2655 (91-13,548) copies/mL respectively. Overall, 25%
      were receiving ART at enrollment, 16% of whom reported at least 6 months of ART
      receipt. OLD was found in 35 (5%) at enrollment. Increasing age (aOR = 2.08 per
      10-years [95%CI 1.22-3.57], p = 0.007), current smoking (aOR = 3.55 [95%CI
      1.20-10.53], p = 0.02), and CRP (aOR = 1.01 per unit-increase [95%CI 1.00-1.03], 
      p = 0.04) were significantly associated with OLD at enrollment; while increasing 
      CD4 count (aOR = 1.02 per-100 cells/mm3 [95%CI 0.85-1.22], p = 0.82), viral load 
      (aOR = 0.67 per log-increase [95%CI 0.43-1.10], p = 0.12) and receipt of ART (aOR
      = 0.57 [95%CI 0.18-1.75], p = 0.32) were not. The median (IQR) follow-up time was
      18 (12-24) months. Participants with a history of tuberculosis (TB) had a 35 mL
      (95%CI 2-68, p = 0.03) and 57 mL (95%CI 19-96, p = 0.003) per year excess loss of
      FEV1 and FVC respectively. CONCLUSION: Prevalent OLD was associated with older
      age, current smoking and higher CRP levels, but not CD4 counts and ART, in
      HIV-infected South African adults. Better understanding of the long-term effects 
      of TB, smoking and inflammation on lung function in HIV-infected populations is
      urgently needed.
FAU - Gupte, Akshay N
AU  - Gupte AN
AUID- ORCID: http://orcid.org/0000-0002-5179-773X
AD  - Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United
      States of America.
AD  - Center for Clinical Global Health Education (CCGHE), Johns Hopkins University
      School of Medicine, Baltimore, Maryland, United States of America.
FAU - Wong, Michelle L
AU  - Wong ML
AD  - Chris Hani Baragwanath Academic Hospital and Faculty of Health Sciences,
      University of the Witwatersrand, Johannesburg, South Africa.
FAU - Msandiwa, Reginah
AU  - Msandiwa R
AD  - Perinatal HIV Research Unit (PHRU), MRC Soweto Matlosana Collaborating Centre for
      HIV/AIDS and TB, University of the Witwatersrand, Johannesburg, South Africa.
FAU - Barnes, Grace L
AU  - Barnes GL
AD  - Center for Tuberculosis Research, Johns Hopkins University School of Medicine,
      Baltimore, Maryland, United States of America.
FAU - Golub, Jonathan
AU  - Golub J
AD  - Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United
      States of America.
AD  - Center for Tuberculosis Research, Johns Hopkins University School of Medicine,
      Baltimore, Maryland, United States of America.
FAU - Chaisson, Richard E
AU  - Chaisson RE
AD  - Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United
      States of America.
AD  - Center for Tuberculosis Research, Johns Hopkins University School of Medicine,
      Baltimore, Maryland, United States of America.
FAU - Hoffmann, Christopher J
AU  - Hoffmann CJ
AD  - Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United
      States of America.
AD  - Center for Tuberculosis Research, Johns Hopkins University School of Medicine,
      Baltimore, Maryland, United States of America.
FAU - Martinson, Neil A
AU  - Martinson NA
AD  - Perinatal HIV Research Unit (PHRU), MRC Soweto Matlosana Collaborating Centre for
      HIV/AIDS and TB, University of the Witwatersrand, Johannesburg, South Africa.
AD  - Center for Tuberculosis Research, Johns Hopkins University School of Medicine,
      Baltimore, Maryland, United States of America.
LA  - eng
PT  - Journal Article
DEP - 20170913
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Anti-Retroviral Agents)
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Anti-Retroviral Agents/adverse effects/therapeutic use
MH  - CD4 Lymphocyte Count
MH  - Cohort Studies
MH  - Female
MH  - HIV Infections/*complications
MH  - Humans
MH  - Logistic Models
MH  - Lung Diseases, Obstructive/complications/*epidemiology
MH  - Male
MH  - Risk Factors
MH  - Smoking
MH  - South Africa
MH  - Viral Load
PMC - PMC5597201
EDAT- 2017/09/14 06:00
MHDA- 2017/10/25 06:00
CRDT- 2017/09/14 06:00
PHST- 2017/05/08 00:00 [received]
PHST- 2017/08/25 00:00 [accepted]
PHST- 2017/09/14 06:00 [entrez]
PHST- 2017/09/14 06:00 [pubmed]
PHST- 2017/10/25 06:00 [medline]
AID - 10.1371/journal.pone.0184530 [doi]
AID - PONE-D-17-17716 [pii]
PST - epublish
SO  - PLoS One. 2017 Sep 13;12(9):e0184530. doi: 10.1371/journal.pone.0184530.
      eCollection 2017.