Lung function in men with and without HIV

Ken M. Kunisaki; Mehdi Nouraie; Robert L. Jensen; Dong Chang; Gypsyamber D'Souza; Meghan E. Fitzpatrick; Meredith C. McCormack; Valentina Stosor; Alison Morris

doi:10.1097/QAD.0000000000002526

Lung function in men with and without HIV

Ken M. Kunisaki^*, Mehdi Nouraie, Robert L. Jensen, Dong Chang, Gypsyamber D'Souza, Meghan E. Fitzpatrick, Meredith C. McCormack, Valentina Stosor, Alison Morris

^*Corresponding author for this work

Medicine, Infectious Diseases Division

Research output: Contribution to journal › Article › peer-review

25 Scopus citations

Abstract

Objectives: Initial studies suggest HIV-positive persons may be at increased risk for chronic lung diseases such as chronic obstructive pulmonary disease, but have commonly relied on single-center designs, lacked HIV-negative controls, or assessed lung function with only spirometry. We tested differences in spirometry and single-breath diffusing capacity for carbon monoxide (DL_CO) in persons with and without HIV. Design: Cross-sectional, observational study. Methods: Participants were enrolled from the Multicenter AIDS Cohort Study, a longitudinal cohort study of men who have sex with men (both HIV-positive and HIV-negative) at four sites in the United States. Standardized spirometry and DL_CO testing were performed in all eligible, consenting participants at routine study visits. We tested associations between HIV status and spirometry and DL_CO results, using linear and logistic regression. Results: Among 1067 men, median age was 57 years, prevalence of current marijuana (30%), and cigarette (24%) use was high, and another 45% were former cigarette smokers. Median forced expiratory volume in 1 s was 97% of predicted normal and DL_CO was 85% of predicted normal. HIV-positive persons demonstrated no statistical difference in forced expiratory volume in 1 s compared with HIV-negative persons, but had worse DL_CO (adjusted difference -2.6% of predicted; 95% confidence interval: -4.7 to -0.6%) and a higher risk of DL_CO impairment (odds ratio for DL_CO < 60% of predicted 2.97; 95% confidence interval: 1.36-6.47). Lower DL_CO was associated with lower nadir CD4^þ cell counts. Conclusion: HIV-positive men are at increased risk of abnormal gas exchange, indicated by low DL_CO, compared with men without HIV.

Original language	English (US)
Pages (from-to)	1227-1235
Number of pages	9
Journal	AIDS
Volume	34
Issue number	8
DOIs	https://doi.org/10.1097/QAD.0000000000002526
State	Published - 2020

Funding

All authors have received grant support from NIH for the work presented here. K.M.K. has received consultancy fees from GlaxoSmithKline and Nuvaira, Inc. outside the work presented here; has received contracted clinical trial support from AstraZeneca and Sanofi outside the work presented here. R.J. has received consultancy fees from ndd Medical Technologies. D.C., G.D., M.E.F., V.S., and A.M.: nothing to declare. M.C.M. has received consultancy fees from GlaxoSmithKline and royalties from UpToDate outside the work presented here. Data in this article were collected by the Multicenter AIDS Cohort Study (MACS), now the MACS/WIHS Combined Cohort Study (MWCCS). MWCCS (Principal Investigators): Atlanta CRS (Ighovwerha Ofotokun, Anandi Sheth, and Gina Wingood), U01-HL146241; Baltimore CRS (Todd Brown and Joseph Margolick), U01-HL146201; Bronx CRS (Kathryn Anastos and Anjali Sharma), U01-HL146204; Brooklyn CRS (Deborah Gustafson and Tracey Wilson), U01-HL146202; Data Analysis and Coordination Center (Gypsyamber D’Souza, Stephen Gange and Elizabeth Golub), U01-HL146193; Chicago-Cook County CRS (Mardge Cohen and Audrey French), U01-HL146245; Chicago-Northwestern CRS (Steven Wolinsky), U01-HL146240; Connie Wofsy Women’s HIV Study, Northern California CRS (Bradley Aouizerat and Phyllis Tien), U01-HL146242; Los Angeles CRS (Roger Detels), U01-HL146333; Metropolitan Washington CRS (Seble Kassaye and Daniel Merenstein), U01-HL146205; Miami CRS (Maria Alcaide, Margaret Fischl, and Deborah Jones), U01-HL146203; Pittsburgh CRS (Jeremy Martinson and Charles Rinaldo), U01-HL146208; UAB-MS CRS (Mirjam-Colette Kempf and Deborah Konkle-Parker), U01-HL146192; UNC CRS (Adaora Adimora), U01-HL146194. The MWCCS is funded primarily by the National Heart, Lung, and Blood Institute (NHLBI), with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Human Genome Research Institute (NHGRI), National Institute on Aging (NIA), National Institute of Dental & Craniofacial Research (NIDCR), National Institute of Allergy And Infectious Diseases (NIAID), National Institute of Neurological Disorders And Stroke (NINDS), National Institute of Mental Health (NIMH), National Institute on Drug Abuse (NIDA), National Institute of Nursing Research (NINR), National Cancer Institute (NCI), National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute on Deafness and Other Communication Disorders (NIDCD), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). MWCCS data collection is also supported by UL1-TR000004 (UCSF CTSA), P30-AI-050409 (Atlanta CFAR), P30-AI-050410 (UNC CFAR), and P30-AI-027767 (UAB CFAR). The Minneapolis Veterans Affairs Healthcare System and Veterans Health Administration Office of Research and Development also provided protected research time in support of this study.

Keywords

Chronic obstructive
HIV
Pulmonary disease
Pulmonary gas exchange
Respiratory function tests
Spirometry

ASJC Scopus subject areas

Infectious Diseases
Immunology and Allergy
Immunology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1097/QAD.0000000000002526

Cite this

@article{367c3dbecb9042c0b09f9e65e1a23be1,

title = "Lung function in men with and without HIV",

abstract = "Objectives: Initial studies suggest HIV-positive persons may be at increased risk for chronic lung diseases such as chronic obstructive pulmonary disease, but have commonly relied on single-center designs, lacked HIV-negative controls, or assessed lung function with only spirometry. We tested differences in spirometry and single-breath diffusing capacity for carbon monoxide (DLCO) in persons with and without HIV. Design: Cross-sectional, observational study. Methods: Participants were enrolled from the Multicenter AIDS Cohort Study, a longitudinal cohort study of men who have sex with men (both HIV-positive and HIV-negative) at four sites in the United States. Standardized spirometry and DLCO testing were performed in all eligible, consenting participants at routine study visits. We tested associations between HIV status and spirometry and DLCO results, using linear and logistic regression. Results: Among 1067 men, median age was 57 years, prevalence of current marijuana (30%), and cigarette (24%) use was high, and another 45% were former cigarette smokers. Median forced expiratory volume in 1 s was 97% of predicted normal and DLCO was 85% of predicted normal. HIV-positive persons demonstrated no statistical difference in forced expiratory volume in 1 s compared with HIV-negative persons, but had worse DLCO (adjusted difference -2.6% of predicted; 95% confidence interval: -4.7 to -0.6%) and a higher risk of DLCO impairment (odds ratio for DLCO < 60% of predicted 2.97; 95% confidence interval: 1.36-6.47). Lower DLCO was associated with lower nadir CD4{\th} cell counts. Conclusion: HIV-positive men are at increased risk of abnormal gas exchange, indicated by low DLCO, compared with men without HIV.",

keywords = "Chronic obstructive, HIV, Pulmonary disease, Pulmonary gas exchange, Respiratory function tests, Spirometry",

author = "Kunisaki, {Ken M.} and Mehdi Nouraie and Jensen, {Robert L.} and Dong Chang and Gypsyamber D'Souza and Fitzpatrick, {Meghan E.} and McCormack, {Meredith C.} and Valentina Stosor and Alison Morris",

year = "2020",

doi = "10.1097/QAD.0000000000002526",

language = "English (US)",

volume = "34",

pages = "1227--1235",

journal = "AIDS",

issn = "0269-9370",

publisher = "Lippincott Williams and Wilkins",

number = "8",

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TY - JOUR

T1 - Lung function in men with and without HIV

AU - Kunisaki, Ken M.

AU - Nouraie, Mehdi

AU - Jensen, Robert L.

AU - Chang, Dong

AU - D'Souza, Gypsyamber

AU - Fitzpatrick, Meghan E.

AU - McCormack, Meredith C.

AU - Stosor, Valentina

AU - Morris, Alison

PY - 2020

Y1 - 2020

N2 - Objectives: Initial studies suggest HIV-positive persons may be at increased risk for chronic lung diseases such as chronic obstructive pulmonary disease, but have commonly relied on single-center designs, lacked HIV-negative controls, or assessed lung function with only spirometry. We tested differences in spirometry and single-breath diffusing capacity for carbon monoxide (DLCO) in persons with and without HIV. Design: Cross-sectional, observational study. Methods: Participants were enrolled from the Multicenter AIDS Cohort Study, a longitudinal cohort study of men who have sex with men (both HIV-positive and HIV-negative) at four sites in the United States. Standardized spirometry and DLCO testing were performed in all eligible, consenting participants at routine study visits. We tested associations between HIV status and spirometry and DLCO results, using linear and logistic regression. Results: Among 1067 men, median age was 57 years, prevalence of current marijuana (30%), and cigarette (24%) use was high, and another 45% were former cigarette smokers. Median forced expiratory volume in 1 s was 97% of predicted normal and DLCO was 85% of predicted normal. HIV-positive persons demonstrated no statistical difference in forced expiratory volume in 1 s compared with HIV-negative persons, but had worse DLCO (adjusted difference -2.6% of predicted; 95% confidence interval: -4.7 to -0.6%) and a higher risk of DLCO impairment (odds ratio for DLCO < 60% of predicted 2.97; 95% confidence interval: 1.36-6.47). Lower DLCO was associated with lower nadir CD4þ cell counts. Conclusion: HIV-positive men are at increased risk of abnormal gas exchange, indicated by low DLCO, compared with men without HIV.

AB - Objectives: Initial studies suggest HIV-positive persons may be at increased risk for chronic lung diseases such as chronic obstructive pulmonary disease, but have commonly relied on single-center designs, lacked HIV-negative controls, or assessed lung function with only spirometry. We tested differences in spirometry and single-breath diffusing capacity for carbon monoxide (DLCO) in persons with and without HIV. Design: Cross-sectional, observational study. Methods: Participants were enrolled from the Multicenter AIDS Cohort Study, a longitudinal cohort study of men who have sex with men (both HIV-positive and HIV-negative) at four sites in the United States. Standardized spirometry and DLCO testing were performed in all eligible, consenting participants at routine study visits. We tested associations between HIV status and spirometry and DLCO results, using linear and logistic regression. Results: Among 1067 men, median age was 57 years, prevalence of current marijuana (30%), and cigarette (24%) use was high, and another 45% were former cigarette smokers. Median forced expiratory volume in 1 s was 97% of predicted normal and DLCO was 85% of predicted normal. HIV-positive persons demonstrated no statistical difference in forced expiratory volume in 1 s compared with HIV-negative persons, but had worse DLCO (adjusted difference -2.6% of predicted; 95% confidence interval: -4.7 to -0.6%) and a higher risk of DLCO impairment (odds ratio for DLCO < 60% of predicted 2.97; 95% confidence interval: 1.36-6.47). Lower DLCO was associated with lower nadir CD4þ cell counts. Conclusion: HIV-positive men are at increased risk of abnormal gas exchange, indicated by low DLCO, compared with men without HIV.

KW - Chronic obstructive

KW - HIV

KW - Pulmonary disease

KW - Pulmonary gas exchange

KW - Respiratory function tests

KW - Spirometry

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DO - 10.1097/QAD.0000000000002526

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JO - AIDS

JF - AIDS

IS - 8

ER -

Lung function in men with and without HIV

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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