G Besutti1,2, A Santoro3, R Scaglioni4, S Neri5, S Zona3, A Malagoli3, G Orlando3, B Beghè6, G Ligabue7, P Torricelli7, M Manfredini8, G Pellacani8, L M Fabbri6, G Guaraldi3. 1. Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy. 2. Radiology Unit, AUSL - IRCCS di Reggio Emilia, Reggio Emilia, Italy. 3. Modena HIV Metabolic Clinic, University of Modena and Reggio Emilia, Modena, Italy. 4. Radiology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy. 5. University of Modena and Reggio Emilia, Modena, Italy. 6. Respiratory Disease Unit, University of Modena and Reggio Emilia, Modena, Italy. 7. Radiology Unit, University of Modena and Reggio Emilia, Modena, Italy. 8. Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy.
Abstract
OBJECTIVES: The aim of the study was to describe chronic lung disease in HIV-infected never-smokers by looking at clinical, structural and functional abnormalities. METHODS: This comparative cross-sectional study included 159 HIV-infected never-smoking patients [mean (± standard deviation) age 54.6 ± 9.1 years; 13.2% female; 98.1% with undetectable viral load] and 75 nonmatched never-smoking controls [mean (± standard deviation) age 52.6 ± 6.9 years; 46.7% female]. We examined calcium scoring computer tomography (CT) scans or chest CT scans, all with a lung-dedicated algorithm reconstruction, to assess emphysema and airway disease (respiratory bronchiolitis and/or bronchial wall thickening), tested pulmonary function using spirometry, lung volumes and the diffusion lung capacity of carbon monoxide (DLCO), and assessed respiratory symptoms using the Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT). RESULTS: Twenty-five (17.2%) of the HIV-infected patients versus two (2.7%) of the controls had a CAT score > 10. Only 5% of the HIV-infected patients showed FEV1% < 80%, and 25% had DLCO < 75% of the predicted value. Based on the CT scans, they had increased prevalences, compared with the controls, of airway disease (37% versus 7.9%, respectively) and emphysema (18% versus 4%, respectively), with more severe and more frequent centrilobular disease. After correction for age, sex and clinical factors, HIV infection was significantly associated with CAT > 10 [odds ratio (OR) 7.7], emphysema (OR 4), airway disease (OR 4.5) and DLCO < 75% of predicted (OR 4). CONCLUSIONS: Although comparisons were limited by the different enrolment methods used for HIV-infected patients and controls, the results suggest that never-smoking HIV-infected patients may present with chronic lung damage characterized by CT evidence of airway disease. A minority of them showed respiratory symptoms, without significant functional abnormalities.
OBJECTIVES: The aim of the study was to describe chronic lung disease in HIV-infected never-smokers by looking at clinical, structural and functional abnormalities. METHODS: This comparative cross-sectional study included 159 HIV-infected never-smoking patients [mean (± standard deviation) age 54.6 ± 9.1 years; 13.2% female; 98.1% with undetectable viral load] and 75 nonmatched never-smoking controls [mean (± standard deviation) age 52.6 ± 6.9 years; 46.7% female]. We examined calcium scoring computer tomography (CT) scans or chest CT scans, all with a lung-dedicated algorithm reconstruction, to assess emphysema and airway disease (respiratory bronchiolitis and/or bronchial wall thickening), tested pulmonary function using spirometry, lung volumes and the diffusion lung capacity of carbon monoxide (DLCO), and assessed respiratory symptoms using the Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT). RESULTS: Twenty-five (17.2%) of the HIV-infectedpatients versus two (2.7%) of the controls had a CAT score > 10. Only 5% of the HIV-infectedpatients showed FEV1% < 80%, and 25% had DLCO < 75% of the predicted value. Based on the CT scans, they had increased prevalences, compared with the controls, of airway disease (37% versus 7.9%, respectively) and emphysema (18% versus 4%, respectively), with more severe and more frequent centrilobular disease. After correction for age, sex and clinical factors, HIV infection was significantly associated with CAT > 10 [odds ratio (OR) 7.7], emphysema (OR 4), airway disease (OR 4.5) and DLCO < 75% of predicted (OR 4). CONCLUSIONS: Although comparisons were limited by the different enrolment methods used for HIV-infectedpatients and controls, the results suggest that never-smoking HIV-infectedpatients may present with chronic lung damage characterized by CT evidence of airway disease. A minority of them showed respiratory symptoms, without significant functional abnormalities.
Authors: Rebekka F Thudium; Hedda Ringheim; Andreas Ronit; Hedda Hoel; Thomas Benfield; Amanda Mocroft; Jan Gerstoft; Marius Trøseid; Álvaro H Borges; Sisse R Ostrowski; Jørgen Vestbo; Susanne D Nielsen Journal: Front Immunol Date: 2021-04-14 Impact factor: 7.561
Authors: Nancy P Y Chung; K M Faisal Khan; Mirko Andreoli; Robert J Kaner; Sarah L O'Beirne; Ronald G Crystal Journal: Sci Rep Date: 2022-02-22 Impact factor: 4.379