HIV infection is an independent risk factor for decreased 6-minute walk test distance

Abstract

Background Ambulatory function predicts morbidity and mortality and may be influenced by cardiopulmonary dysfunction. Persons living with HIV (PLWH) suffer from a high prevalence of cardiac and pulmonary comorbidities that may contribute to higher risk of ambulatory dysfunction as measured by 6-minute walk test distance (6-MWD). We investigated the effect of HIV on 6-MWD. Methods PLWH and HIV-uninfected individuals were enrolled from 2 clinical centers and completed a 6-MWD, spirometry, diffusing capacity for carbon monoxide (DL CO ) and St. George’s Respiratory Questionnaire (SGRQ). Results of 6-MWD were compared between PLWH and uninfected individuals after adjusting for confounders. Multivariable linear regression analysis was used to determine predictors of 6-MWD. Results Mean 6-MWD in PLWH was 431 meters versus 462 in 130 HIV-uninfected individuals (p = 0.0001). Older age, lower forced expiratory volume (FEV 1 )% or lower forced vital capacity (FVC)%, and smoking were significant predictors of decreased 6-MWD in PLWH, but not HIV-uninfected individuals. Lower DL CO % and higher SGRQ were associated with lower 6-MWD in both groups. In a combined model, HIV status remained an independent predictor of decreased 6-MWD (Mean difference = -19.9 meters, p = 0.005). Conclusions HIV infection was associated with decreased ambulatory function. Airflow limitation and impaired diffusion capacity can partially explain this effect. Subjective assessments of respiratory symptoms may identify individuals at risk for impaired physical function who may benefit from early intervention.

Espirometría en pacientes infectados con virus de la inmunodeficiencia humana

“…Adicionalmente también se encontró un valor p de 0,004 en relación a VEF1 y el sexo apuntando a la presencia de influencia del sexo sobre los valores de VEF1; Talaminos Barroso et al explicaron como a través de métodos morfométricos se diferenciaban los pulmones entre ambos géneros asociando dichas diferencia al desarrollo pulmonar que sucede en la etapa posnatal (46) evidenciándose en los tamaños pulmonares diferentes que existen entre hombres y mujeres en la etapa neonatal y prepuberal y que se mantienen durante la adultez (47) todo esto con un coeficiente de determinación ajustado del 50% lo que evidencia que el modelo de regresión lineal usado explica solo la mitad de los resultados dejando gran parte de los factores que intervienen en dichos resultados sin determinar.…”

COPD in People with HIV: Epidemiology, Pathogenesis, Management, and Prevention Strategies

“…Among PWH, abnormal DLco, like abnormal FEV1, is an independent predictor of worse respiratory symptoms (such as dyspnea, cough, and mucus production), 170 as well as a worse 6-minute walk test. 177 , 178 Finally, abnormal DLco is an independent predictor of mortality in PWH with COPD. 179 , 180 …”

HIV infection and cardiovascular pathology

“…У ВИЧ-инфицированных людей клинические признаки СН возникают раньше и в более молодом возрасте, чем в популяции в целом [48]. ВИЧинфицированные пациенты преодолевали меньшую дистанцию во время проведения 6-минутного теста ходьбы, при этом успешная вирусная супрессия и высокий уровень CD4+ T-лимфоцитов ассоциировались с повышением толерантности к физической нагрузке [52].…”