Prevalence and predictors of airflow obstruction in an <scp>HIV</scp> tertiary care clinic in Montreal, Canada: a cross‐sectional study

Costiniuk, Cecilia T.; Nitulescu, Roy; Saneei, Zahra; Wasef, Natale; Salahuddin, Syim; Wasef, D; Young, Jim; Castro, Christina De; Routy, Jean‐Pierre; Lebouché, Bertrand; Cox, Joseph; Smith, Benjamin M.; Ambroise, S; Pexos, Costa; Patel, M.H.; Szabo, Jason; Haraoui, Louis-Patrick; Pokomandy, Alexandra de; Tsoukas, Chris; Falutz, Julian; LeBlanc, Roger; Giannakis, Andreas; Frenette, Charles; Jenabian, Mohammad-Ali; Bourbeau, Jean; Klein, Marina B.

doi:10.1111/hiv.12699

Cited by 11 publications

(7 citation statements)

References 49 publications

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“…However, despite early ART, our results indicated that, contrary to the liver, several gene transcripts associated with the acute-phase response, coagulation, and complement remain elevated in the lungs. This persistent alteration of gene expression could contribute to the tissue damage observed in PLWH ( 95 ). Serpins are important regulators of extracellular matrix remodeling, contributing to lung pathology, such as COPD and cystic fibrosis ( 46 ), while tissue factor drives coagulopathy ( 96 ).…”

Section: Discussionmentioning

confidence: 99%

Early ART reduces viral seeding and innate immunity in liver and lungs of SIV-infected macaques

Clain,

Rabezanahary,

Racine

et al. 2023

JCI Insight

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Identifying immune cells and anatomical tissues that contribute to the establishment of viral reservoirs is of central importance in HIV-1 cure research. Herein, we used rhesus macaques (RMs) infected with SIVmac251 to analyze viral seeding in the liver and lungs of either untreated or early antiretroviral therapy–treated (ART-treated) RMs. Consistent with viral replication and sensing, transcriptomic analyses showed higher levels of inflammation, pyroptosis, and chemokine genes as well as of interferon-stimulating gene (ISG) transcripts, in the absence of ART. Our results highlighted the infiltration of monocyte-derived macrophages (HLA-DR + CD11b + CD14 + CD16 + ) in inflamed liver and lung tissues associated with the expression of CD183 and CX3CR1 but also with markers of tissue-resident macrophages (CD206 + and LYVE + ). Sorting of myeloid cell subsets demonstrated that CD14 + CD206 – , CD14 + CD206 + , and CD14 – CD206 + cell populations were infected, in the liver and lungs, in SIVmac251-infected RMs. Of importance, early ART drastically reduced viral seeding consistent with the absence of ISG detection but also of genes related to inflammation and tissue damage. Viral DNA was only detected in CD206 + HLA-DR + CD11b + cells in ART-treated RMs. The observation of pulmonary and hepatic viral rebound after ART interruption reinforces the importance of early ART implementation to limit viral seeding and inflammatory reactions.

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Section: Discussionmentioning

confidence: 99%

Early ART reduces viral seeding and innate immunity in liver and lungs of SIV-infected macaques

Clain,

Rabezanahary,

Racine

et al. 2023

JCI Insight

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“…We found that baseline current smoking and more pack-years of smoking were associated with the low baseline, slow decline FEV 1 trajectory, moderate decline and rapid decline FEV 1 /FVC trajectories, and baseline low DL CO trajectory. Current smoking and pack-years of smoking have been identified as independent predictors of airflow and diffusion impairment in cross-sectional studies (4,7,21,37,(46)(47)(48) and of faster decline in pulmonary function in longitudinal cohorts (14,21,37,38). Our study, which integrates baseline and longitudinal data to identify lung function trajectories and has longer follow-up (median, 8.1 yr vs. 1.5-6.3 yr in earlier cohorts), provides additional evidence on the detrimental relationship between smoking and lung function in PWH.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Function Trajectories in People with HIV: Analysis of the Pittsburgh HIV Lung Cohort

Konstantinidis¹,

Qin²,

Fitzpatrick³

et al. 2022

Annals ATS

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Rationale: Human immunodeficiency virus (HIV) infection is associated with chronic lung disease and impaired pulmonary function; however, longitudinal pulmonary function phenotypes in HIV are undefined.Objectives: To identify pulmonary function trajectories, their determinants, and outcomes.Methods: We used data from participants with HIV in the Pittsburgh HIV Lung Cohort with three or more pulmonary function tests between 2007 and 2020. We analyzed post-bronchodilator forced expiratory volume in 1 second (FEV 1 ), forced vital capacity (FVC), and FEV 1 /FVC, and diffusing capacity of the lung for carbon monoxide (DL CO ) using group-based trajectory modeling to identify subgroups of individuals whose measurements followed a similar pattern over time. We examined the association between participant characteristics and trajectories using multivariable logistic regression. In exploratory adjusted analyses restricted to individuals with available plasma cytokine data, we investigated the association between 18 individual standardized cytokine concentrations and trajectories. We compared mortality, dyspnea prevalence, respiratory health status, and 6-minute-walk distance between phenotypes.Results: A total of 265 participants contributed 1,606 pulmonary function measurements over a median follow-up of 8.1 years. We identified two trajectories each for FEV 1 and FVC: "low baseline, slow decline" and "high baseline, rapid decline." There were three trajectory groups for FEV 1 /FVC: "rapid decline," "moderate decline," and "slow decline." Finally, we identified two trajectories for DL CO : "baseline low" and "baseline high." The low baseline, slow decline FEV 1 and FVC, rapid decline, and moderate decline FEV 1 /FVC, and baseline low DL CO phenotypes were associated with increased dyspnea prevalence, worse respiratory health status, and decreased 6-minute-walk distance. The baseline low DL CO phenotype was also associated with worse mortality. Current smoking and pack-years of smoking were associated with the adverse FEV 1 , FEV 1 /FVC, and DL CO phenotypes. Detectable viremia was the only HIV marker associated with the adverse DL CO phenotype. C-reactive protein and endothelin-1 were associated with the adverse FEV 1 and FVC phenotypes, and endothelin-1 trended toward an association with the adverse DL CO phenotype.Conclusions: We identified novel, distinct longitudinal pulmonary function phenotypes with significant differences in characteristics and outcomes. These findings highlight the importance of lung dysfunction over time in people with HIV and should be validated in additional cohorts.

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“…While several studies have evaluated different screening approaches, no conclusive recommendations can be made regarding COPD screening and diagnosis in PWH at this time. 150,[153][154][155][156] For example, a group in Canada offered screening spirometry to all patients in an HIV clinic; 156 notably, less than a third of the invited participants agreed to participate, and only 11% had airflow obstruction.…”

Section: Diagnosis and Clinical Findings Of Copd In Pwh Screening And...mentioning

confidence: 99%

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

Byanova,

Abelman,

North

et al. 2023

COPD

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Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder characterized by airflow limitation and persistent respiratory symptoms. People with HIV (PWH) are particularly vulnerable to COPD development; PWH have demonstrated both higher rates of COPD and an earlier and more rapid decline in lung function than their seronegative counterparts, even after accounting for differences in cigarette smoking. Factors contributing to this HIV-associated difference include chronic immune activation and inflammation, accelerated aging, a predilection for pulmonary infections, alterations in the lung microbiome, and the interplay between HIV and inhalational toxins. In this review, we discuss what is known about the epidemiology and pathobiology of COPD among PWH and outline screening, diagnostic, prevention, and treatment strategies.

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Prevalence and predictors of airflow obstruction in an HIV tertiary care clinic in Montreal, Canada: a cross‐sectional study

Cited by 11 publications

References 49 publications

Early ART reduces viral seeding and innate immunity in liver and lungs of SIV-infected macaques

Early ART reduces viral seeding and innate immunity in liver and lungs of SIV-infected macaques

Pulmonary Function Trajectories in People with HIV: Analysis of the Pittsburgh HIV Lung Cohort

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

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