Abstract
People living with HIV (PLWH) may be more susceptible to the development of emphysema than uninfected individuals. We assessed prevalence and risk factors for emphysema in PLWH and uninfected controls. Spirometry and chest computed tomography scans were obtained in PLWH from the Copenhagen Comorbidity in HIV Infection (COCOMO) study and in uninfected controls from the Copenhagen General Population Study (CGPS) who were >40 years. Emphysema was quantified using a low attenuation area < −950 Hounsfield units (%LAA-950) and the 15th percentile density index (PD15) and assessed by semi-quantitative visual scales. Of 742 PLWH, 21.2% and 4.7% had emphysema according to the %LAA-950 threshold with cut-offs at 5% and 10%, respectively. Of 470 uninfected controls, these numbers were 24.3% (p=0.23) and 4.0% (p=0.68). HIV was not associated with emphysema (adjusted OR 1.25, 95% CI 0.68–2.36 for %LAA-950 >10%) by PD15 or by visually assessed emphysema. We found no interaction between HIV and cumulative smoking. Breathlessness and sputum production were more common in PLWH with emphysema, and emphysema seemed to be more prevalent in PLWH with airflow limitation. HIV was therefore not independently associated with emphysema, but the clinical impact of emphysema was greater in PLWH than in uninfected controls.
Abstract
Well-treated HIV infection is not associated with emphysema http://ow.ly/2IA430khHvy
Footnotes
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Author contributions: A. Ronit was responsible for the concept, data collection and statistical analysis, and drafted the manuscript. T. Kristensen was responsible for the concept and data collection, and edited the manuscript. V.S. Hoseth was responsible for data collection and edited the manuscript. D. Abou-Kassem was responsible for data collection and edited the manuscript. J.T. Kühl was responsible for the concept and edited the manuscript. T. Benfield was responsible for the concept and edited the manuscript. J. Gerstoft was responsible for the concept and edited the manuscript. S. Afzal was responsible for the concept and data collection, and edited the manuscript. B.G. Nordestgaard was responsible for the concept and data collection, and edited the manuscript. J.D. Lundgren was responsible for the concept and edited the manuscript. J. Vestbo was responsible for the concept and edited the manuscript. K.F. Kofoed was responsible for the concept and edited the manuscript. S.D. Nielsen was responsible for the concept and data collection, and edited the manuscript.
Conflict of interest: T. Benfield reports personal fees for advisory board activities from Bristol Myers Squibb, Gilead and Abbvie, personal fees for lectures including service on speakers bureau from Bristol Myers Squibb and GSK, personal fees for development of educational presentations from Bristol Myers Squibb and GSK, and non-financial support (travel/accommodation/meeting expenses) from Bristol Myers Squibb and Gilead, outside the submitted work.
Conflict of interest: J. Gerstoft reports honoraria for consulting and presenting paid to his institution from Gilead, Abbvie, ViiV, BMS, MSD, Janssen and Medivir, outside the submitted work.
Conflict of interest: J. Vestbo reports honoraria for consulting and presenting from AstraZeneca, Boehringer Ingelheim, Chiesi, GSK and Novartis, outside the submitted work.
Conflict of interest: K.F. Kofoed reports personal fees for advisory board activity from Gilead, outside the submitted work.
Conflict of interest: S.D. Nielsen reports unrestricted research grants from Novo Nordisk Foundation, Lundbeck Foundation, Augustinus Foundation and Rigshospitalet Research Council, travelling grants from Gilead, MSD, BMS and GSK/ViiV, and advisory board activity for Gilead and GSK/ViiV, outside the submitted work.
Support statement: This work was supported by Rigshospitalet Research Council, Region Hovedstaden, The Lundbeck Foundation, The Novo Nordisk Foundation, The Danish National Research Foundation grant 126 and AP Møller og hustru Chastine McKinney Møllers Fond. The study was designed, conducted, analysed and written by the authors without involvement of any commercial party. Funding information for this article has been deposited with the Crossref Funder Registry.
- Received February 9, 2018.
- Accepted May 22, 2018.
- Copyright ©ERS 2018
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