Significant chronic airway abnormalities in never-smoking HIV-infected patients

G. Besutti, A. Santoro, R. Scaglioni, S. Neri, S. Zona, A. Malagoli, G. Orlando, B. Beghè, G. Ligabue, P. Torricelli, M. Manfredini, G. Pellacani, L. M. Fabbri, G. Guaraldi

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)657-667
Number of pages11
JournalHIV Medicine
Volume20
Issue number10
DOIs
Publication statusPublished - Nov 1 2019

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Smoking
HIV
Lung Volume Measurements
Lung
Tomography
Emphysema
Carbon Monoxide
Chronic Obstructive Pulmonary Disease
Bronchiolitis
Spirometry
Viral Load
Lung Diseases
Chronic Disease
Thorax
Cross-Sectional Studies
Odds Ratio
Calcium

Keywords

  • chronic obstructive pulmonary disease
  • HIV-1
  • multidetector computed tomography
  • respiratory function tests
  • respiratory signs and symptoms

ASJC Scopus subject areas

  • Health Policy
  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Besutti, G., Santoro, A., Scaglioni, R., Neri, S., Zona, S., Malagoli, A., ... Guaraldi, G. (2019). Significant chronic airway abnormalities in never-smoking HIV-infected patients. HIV Medicine, 20(10), 657-667. https://doi.org/10.1111/hiv.12785

Significant chronic airway abnormalities in never-smoking HIV-infected patients. / Besutti, G.; Santoro, A.; Scaglioni, R.; Neri, S.; Zona, S.; Malagoli, A.; Orlando, G.; Beghè, B.; Ligabue, G.; Torricelli, P.; Manfredini, M.; Pellacani, G.; Fabbri, L. M.; Guaraldi, G.

In: HIV Medicine, Vol. 20, No. 10, 01.11.2019, p. 657-667.

Research output: Contribution to journalArticle

Besutti, G, Santoro, A, Scaglioni, R, Neri, S, Zona, S, Malagoli, A, Orlando, G, Beghè, B, Ligabue, G, Torricelli, P, Manfredini, M, Pellacani, G, Fabbri, LM & Guaraldi, G 2019, 'Significant chronic airway abnormalities in never-smoking HIV-infected patients', HIV Medicine, vol. 20, no. 10, pp. 657-667. https://doi.org/10.1111/hiv.12785
Besutti G, Santoro A, Scaglioni R, Neri S, Zona S, Malagoli A et al. Significant chronic airway abnormalities in never-smoking HIV-infected patients. HIV Medicine. 2019 Nov 1;20(10):657-667. https://doi.org/10.1111/hiv.12785
Besutti, G. ; Santoro, A. ; Scaglioni, R. ; Neri, S. ; Zona, S. ; Malagoli, A. ; Orlando, G. ; Beghè, B. ; Ligabue, G. ; Torricelli, P. ; Manfredini, M. ; Pellacani, G. ; Fabbri, L. M. ; Guaraldi, G. / Significant chronic airway abnormalities in never-smoking HIV-infected patients. In: HIV Medicine. 2019 ; Vol. 20, No. 10. pp. 657-667.
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AU - Santoro, A.

AU - Scaglioni, R.

AU - Neri, S.

AU - Zona, S.

AU - Malagoli, A.

AU - Orlando, G.

AU - Beghè, B.

AU - Ligabue, G.

AU - Torricelli, P.

AU - Manfredini, M.

AU - Pellacani, G.

AU - Fabbri, L. M.

AU - Guaraldi, G.

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N2 - 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.

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KW - HIV-1

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