Changes in lung function of <scp>HIV</scp>‐infected patients: a 4·5‐year follow‐up study

Kristoffersen, Ulrik Sloth; Lebech, Anne‐Mette; Mortensen, Jann; Gerstoft, Jan; Gutte, Henrik; Kjær, Andreas

doi:10.1111/j.1475-097x.2012.01124.x

Cited by 54 publications

(60 citation statements)

References 19 publications

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“…48,49 Kristoffersen and colleagues 48 followed up 88 HIV-infected patients with measurements for spirometry and DLCO at baseline and again at a median follow-up of 4·5 years. Nearly all the patients in this cohort were receiving ART and 40% were smokers.…”

Section: Abnormalities In Pulmonary Function Tests In Patients With Hivmentioning

confidence: 99%

HIV-associated obstructive lung diseases: insights and implications for the clinician

Drummond¹,

Kirk²

2014

The Lancet Respiratory Medicine

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The effectiveness of antiretroviral therapy to control HIV infection has led to the emergence of an older HIV population who are at risk of chronic diseases. Through a comprehensive search of major databases, this Review summarises information about the associations between chronic obstructive pulmonary disease (COPD), asthma, and HIV infection. Asthma and COPD are more prevalent in HIV-infected populations; 16–20% of individuals with HIV infection have asthma or COPD, and poorly controlled HIV infection worsens spirometric and diffusing capacity measurements, and accelerates lung function decline by about 55–75 mL/year. Up to 21% of HIV-infected individuals have obstructive ventilatory defects and reduced diffusing capacity is seen in more than 50% of HIV-infected populations. Specific pharmacotherapy considerations are needed to care for HIV-infected populations with asthma or COPD–protease inhibitor regimens to treat HIV (such as ritonavir) can result in systemic accumulation of inhaled corticosteroids and might increase pneumonia risk, exacerbating the toxicity of this therapy. Therefore, it is essential for clinicians to have a heightened awareness of the increased risk and manifestations of obstructive lung diseases in HIV-infected patients and specific therapeutic considerations to care for this population. Screening spirometry and tests of diffusing capacity might be beneficial in HIV-infected people with a history of smoking or respiratory symptoms.

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Section: Abnormalities In Pulmonary Function Tests In Patients With Hivmentioning

confidence: 99%

HIV-associated obstructive lung diseases: insights and implications for the clinician

Drummond¹,

Kirk²

2014

The Lancet Respiratory Medicine

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“…These findings are consistent with supportive evidence from other studies. Continuous ART is associated with a decreased risk overall of AIDS and non-AIDS events (37), and ART has been suggested to have a protective effect on pulmonary function (38). Within the alveolar space, ART also decreases pulmonary HIV viral load and decreases nonspecific pulmonary inflammation (39,40).…”

Section: Table 2 Incidence Rate Ratio For the Association Of Hiv Infmentioning

confidence: 99%

HIV Infection and Risk for Incident Pulmonary Diseases in the Combination Antiretroviral Therapy Era

Crothers

Huang²,

Goulet³

et al. 2011

Am J Respir Crit Care Med

365

338

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“…19,24 Studies show that in addition, HIV infected patients with higher HIV viral loads or lower CD4 T-cell counts have more rapid decline in pulmonary function, worse disease, and likely worse diffusing capacity than similar patients without HIV. 2,4,31,32 Whether peak flow is influenced by these factors in a similar manner remains less clear.…”

mentioning

confidence: 99%

Screening for Chronic Obstructive Pulmonary Disease (COPD) in an Urban HIV Clinic: A Pilot Study

Shirley¹,

Kaner

Glesby

2015

AIDS Patient Care and STDs

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Increased smoking and a detrimental response to tobacco smoke in the lungs of HIV/AIDS patients result in an increased risk for COPD. We aimed to determine the predictive value of a COPD screening strategy validated in the general population and to identify HIV-related factors associated with decreased lung function. Subjects at least 35 years of age at an HIV clinic in New York City completed a COPD screening questionnaire and peak flow measurement. Those with abnormal results and a random one-third of normal screens had spirometry. 235 individuals were included and 89 completed spirometry. Eleven (12%) had undiagnosed airway obstruction and 5 had COPD. A combination of a positive questionnaire and abnormal peak flow yielded a sensitivity of 20% (specificity 93%) for detection of COPD. Peak flow alone had a sensitivity of 80% (specificity 80%). Abnormal peak flow was associated with an AIDS diagnosis ( p = 0.04), lower nadir ( p = 0.001), and current CD4 counts ( p = 0.001). Nadir CD4 remained associated in multivariate analysis (p = 0.05). Decreased FEV1 ( < 80% predicted) was associated with lower CD4 count nadir ( p = 0.04) and detectable current HIV viral load ( p = 0.01) in multivariate analysis. Questionnaire and peak flow together had low sensitivity, but abnormal peak flow shows potential as a screening tool for COPD in HIV/AIDS. These data suggest that lung function may be influenced by HIV-related factors.

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Changes in lung function of HIV‐infected patients: a 4·5‐year follow‐up study

Abstract: Carbon monoxide diffusion capacity is reduced in HIV-infected patients and seems to decline over time. Additionally, signs of obstructive lung disease are present in HIV-infected patients and seem to increase over time, although only modestly.

Cited by 54 publications

References 19 publications

HIV-associated obstructive lung diseases: insights and implications for the clinician

HIV-associated obstructive lung diseases: insights and implications for the clinician

HIV Infection and Risk for Incident Pulmonary Diseases in the Combination Antiretroviral Therapy Era

Screening for Chronic Obstructive Pulmonary Disease (COPD) in an Urban HIV Clinic: A Pilot Study

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