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The burden of image based emphysema and bronchiolitis in HIV-infected individuals on antiretroviral therapy.
- Source :
-
PloS one [PLoS One] 2014 Oct 29; Vol. 9 (10), pp. e109027. Date of Electronic Publication: 2014 Oct 29 (Print Publication: 2014). - Publication Year :
- 2014
-
Abstract
- Background: With the widespread use of anti-retroviral therapy (ART), individuals infected with human immune deficiency virus (HIV) are increasingly experiencing morbidity and mortality from respiratory disorders. However, the prevalence or the risk factors associated with emphysema and bronchiolitis are largely unknown.<br />Methods: Thoracic computed tomography (CT) scans were performed in 1,446 patients infected with HIV who were on ART and who attended a tertiary care metabolic clinic (average age 48 years and 29% females). Detailed history and physical examination including anthropometric measurements were performed. Complete pulmonary function tests were performed in a subset of these patients (n = 364). No subjects were acutely ill with a respiratory condition at the time of CT scanning.<br />Findings: Nearly 50% of the subjects had CT evidence for emphysema, bronchiolitis or both with 13% (n = 195) showing bronchiolitis, 19% (n = 274) showing emphysema and 16% (n = 238) revealing both. These phenotypes were synergistically associated with reduced regular physical activity (p for interaction <.0001). The most significant risk factors for both phenotypes were cigarette smoking, intravenous drug use and peripheral leucocytosis. Together, the area-under-the curve statistics was 0.713 (p = 0.0037) for discriminating those with and without these phenotypes. There were no significant changes in lung volumes or flow rates related to these phenotypes, though the carbon monoxide diffusion capacity was reduced for the emphysema phenotype.<br />Interpretation: Emphysema and bronchiolitis are extremely common in HIV-infected patients who are treated with ART and can be identified by use of thoracic CT scanning.
- Subjects :
- Adult
Area Under Curve
Bronchiolitis physiopathology
Female
HIV Infections complications
HIV Infections diagnostic imaging
Humans
Male
Middle Aged
Prospective Studies
Pulmonary Emphysema physiopathology
Respiratory Function Tests
Risk Factors
Tomography, X-Ray Computed
Anti-Retroviral Agents administration & dosage
Bronchiolitis diagnostic imaging
Bronchiolitis etiology
HIV Infections drug therapy
Pulmonary Emphysema diagnostic imaging
Pulmonary Emphysema etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1932-6203
- Volume :
- 9
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- PloS one
- Publication Type :
- Academic Journal
- Accession number :
- 25354261
- Full Text :
- https://doi.org/10.1371/journal.pone.0109027