Airflow limitation in people living with HIV and matched uninfected controls

TY - JOUR

T1 - Airflow limitation in people living with HIV and matched uninfected controls

AU - Ronit, Andreas

AU - Lundgren, Jens

AU - Afzal, Shoaib

AU - Benfield, Thomas

AU - Roen, Ashley

AU - Mocroft, Amanda

AU - Gerstoft, Jan

AU - Nordestgaard, Børge G

AU - Vestbo, Jørgen

AU - Nielsen, Susanne D

AU - Copenhagen Co-morbidity in HIV infection (COCOMO) study group

N1 - © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

PY - 2018/5/1

Y1 - 2018/5/1

N2 - INTRODUCTION: Whether HIV influences pulmonary function remains controversial. We assessed dynamic pulmonary function in people living with HIV (PLWHIV) and uninfected controls. METHODS: A total of 1098 PLWHIV from the Copenhagen Co-morbidity in HIV infection study and 12 161 age-matched and sex-matched controls from the Copenhagen General Population Study were included. Lung function was assessed using FEV1 and FVC, while airflow limitation was defined by the lower limit of normal (LLN) of FEV1/FVC and by FEV1/FVC<0.7 with FEV1predicted <80% (fixed). Logistic and linear regression models were used to determine the association between HIV and pulmonary function adjusting for potential confounders (including smoking and socioeconomic status). RESULTS: In predominantly white men with mean (SD) age of 50.6 (11.1) the prevalence of airflow limitation (LLN) was 10.6% (95% CI 8.9% to 12.6%) in PLWHIV and 10.6% (95% CI 10.0 to 11.1) in uninfected controls. The multivariable adjusted OR for airflow limitation defined by LLN for HIV was 0.97 (0.77-1.21, P<0.78) and 1.71 (1.34-2.16, P<0.0001) when defined by the fixed criteria. We found no evidence of interaction between HIV and cumulative smoking in these models (P interaction: 0.25 and 0.17 for LLN and fixed criteria, respectively). HIV was independently associated with 197 mL (152-242, P<0.0001) lower FEV1 and 395 mL (344-447, P<0.0001) lower FVC, and 100 cells/mm3 lower CD4 nadir was associated with 30 mL (7-52, P<0.01) lower FEV1 and 51 mL (24-78, P<0.001) lower FVC. CONCLUSION: HIV is a risk factor for concurrently decreased FEV1 and FVC. This excess risk is not explained by smoking or socioeconomic status and may be mediated by prior immunodeficiency. TRIAL REGISTRATION NUMBER: NCT02382822.

AB - INTRODUCTION: Whether HIV influences pulmonary function remains controversial. We assessed dynamic pulmonary function in people living with HIV (PLWHIV) and uninfected controls. METHODS: A total of 1098 PLWHIV from the Copenhagen Co-morbidity in HIV infection study and 12 161 age-matched and sex-matched controls from the Copenhagen General Population Study were included. Lung function was assessed using FEV1 and FVC, while airflow limitation was defined by the lower limit of normal (LLN) of FEV1/FVC and by FEV1/FVC<0.7 with FEV1predicted <80% (fixed). Logistic and linear regression models were used to determine the association between HIV and pulmonary function adjusting for potential confounders (including smoking and socioeconomic status). RESULTS: In predominantly white men with mean (SD) age of 50.6 (11.1) the prevalence of airflow limitation (LLN) was 10.6% (95% CI 8.9% to 12.6%) in PLWHIV and 10.6% (95% CI 10.0 to 11.1) in uninfected controls. The multivariable adjusted OR for airflow limitation defined by LLN for HIV was 0.97 (0.77-1.21, P<0.78) and 1.71 (1.34-2.16, P<0.0001) when defined by the fixed criteria. We found no evidence of interaction between HIV and cumulative smoking in these models (P interaction: 0.25 and 0.17 for LLN and fixed criteria, respectively). HIV was independently associated with 197 mL (152-242, P<0.0001) lower FEV1 and 395 mL (344-447, P<0.0001) lower FVC, and 100 cells/mm3 lower CD4 nadir was associated with 30 mL (7-52, P<0.01) lower FEV1 and 51 mL (24-78, P<0.001) lower FVC. CONCLUSION: HIV is a risk factor for concurrently decreased FEV1 and FVC. This excess risk is not explained by smoking or socioeconomic status and may be mediated by prior immunodeficiency. TRIAL REGISTRATION NUMBER: NCT02382822.

KW - Adult

KW - CD4 Lymphocyte Count

KW - Case-Control Studies

KW - Female

KW - Forced Expiratory Volume

KW - HIV Infections/blood

KW - Humans

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Risk Factors

KW - Tobacco Smoking/physiopathology

KW - Vital Capacity

U2 - 10.1136/thoraxjnl-2017-211079

DO - 10.1136/thoraxjnl-2017-211079

M3 - Journal article

C2 - 29331988

SN - 0040-6376

VL - 73

SP - 431

EP - 438

JO - Thorax

JF - Thorax

IS - 5

ER -