The Differential Impact of Emphysema on Respiratory Symptoms and 6-Minute Walk Distance in HIV Infection

BACKGROUND:Emphysema is more prevalent in HIV-infected (HIV+) patients independent of smoking behavior. Nonetheless, health effects of emphysema in this population are poorly understood. We determined whether emphysema is associated with a greater burden of pulmonary symptoms and a lower 6-minute wa...

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Veröffentlicht in:Journal of acquired immune deficiency syndromes (1999) 2017-01, Vol.74 (1), p.e23-e29
Hauptverfasser: Triplette, Matthew, Attia, Engi, Akgün, Kathleen, Campo, Monica, Rodriguez-Barradas, Maria, Pipavath, Sudhakar, Shahrir, Shahida, Wongtrakool, Cherry, Goetz, Matthew, Kim, Joon, Soo Hoo, Guy W, Brown, Sheldon T, Crothers, Kristina
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Sprache:eng
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Zusammenfassung:BACKGROUND:Emphysema is more prevalent in HIV-infected (HIV+) patients independent of smoking behavior. Nonetheless, health effects of emphysema in this population are poorly understood. We determined whether emphysema is associated with a greater burden of pulmonary symptoms and a lower 6-minute walk distance (6MWD) in HIV+ compared with HIV-uninfected (HIV−) subjects. METHODS:We performed a cross-sectional analysis of 170 HIV+ and 153 HIV− subjects in the Examinations of HIV-Associated Lung Emphysema (EXHALE) cohort study. Subjects completed a self-assessment of respiratory symptoms, pulmonary function testing, and 6MWD testing as well as a chest computed tomography to determine emphysema severity. We used regression models to determine the association of emphysema with respiratory symptoms and 6MWD in HIV+ subjects and compared this to HIV− subjects. RESULTS:Models stratified by HIV status demonstrated an association between >10% radiographic emphysema and chronic cough and/or phlegm and 6MWD in HIV+ subjects. These associations persisted among the subset without airflow obstructionthose with emphysema had 4.2 (95% confidence interval1.3 to 14) times the odds of chronic cough and/or phlegm and walked 60 m (95% confidence interval26 to 93) less distance than those without emphysema. There was no association between >10% emphysema and symptoms or 6MWD in HIV− subjects. CONCLUSIONS:In our cohort, >10% radiographic emphysema was associated with chronic cough and/or phlegm and lower 6MWD in HIV+ but not HIV− subjects. These findings were robust even among HIV+ subjects with milder forms of emphysema and those without airflow obstruction, highlighting the clinical impact of emphysema in these patients.
ISSN:1525-4135
1944-7884
DOI:10.1097/QAI.0000000000001133