Journal Article

The association between HIV infection and pulmonary function in a rural African population

Barth, Roos E., Varkila, Meri R. J., Vos, Alinda G., Klipstein-Grobusch, Kerstin, Tempelman, Hugo A., Devillé, Walter L. J., Grobbee, Diederick E., Coutinho, Roel A.

2019

Overview

HIV infection has been associated with an impaired lung function in high-income countries, but the association between HIV infection and pulmonary function in Sub-Saharan Africa remains unclear. This study aims to investigate the relation between HIV infection and pulmonary function in a rural African population. A cross-sectional study was conducted among HIV-positive and HIV-negative adults in a rural area in South Africa, as part of the Ndlovu Cohort Study. A respiratory questionnaire and post-bronchodilator spirometry were performed. Multivariable regression analysis was used to investigate whether HIV was independently associated with a decrease in post-bronchodilator FEV1/FVC ratio considering age, sex, body mass index, respiratory risk factors and a history of a pulmonary infection (tuberculosis (TB) or a pneumonia). Possible mediation by a history of pulmonary infection was tested by removing this variable from the final model. Two hundred and one consecutive participants were enrolled in the study in 2016, 84 (41.8%) were HIV-positive (82.1% on ART). The median age was 38 (IQR 29-51) years. Following multivariable analysis HIV was not significantly associated to a decline in post-bronchodilator FEV1/FVC ratio (β -0.017, p 0.18). However, upon removal of a history of a pulmonary infection from the final model HIV was significantly related to post-bronchodilator FEV1/FVC ratio, β -0.026, p 0.03. Pulmonary function is affected by HIV infection which most likely results from co-infection with TB or other pneumonia. Further research should focus on the influence of a pulmonary infection, most notably TB, on pulmonary function, especially as the incidence of TB is high in HIV infection.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Acquired immune deficiency syndrome / Adult / Adults / AIDS / Antiretroviral therapy / Biology and Life Sciences / Body mass / Body mass index / Body size / Bronchodilators / Chronic obstructive pulmonary disease / Cohort Studies / Coinfection - epidemiology / Coinfection - physiopathology / Complications and side effects / Cross-Sectional Studies / Data collection / Drug therapy / Epidemiology / Female / Health aspects / Health care / Health sciences / HIV / HIV infections / HIV Infections - epidemiology / HIV Infections - physiopathology / HIV Infections - virology / Human immunodeficiency virus / Humans / Incidence / Infections / Infectious diseases / Internal medicine / Lungs / Male / Medicine and health sciences / Middle Aged / Pathogenesis / Patient outcomes / Pneumonia / Population / Population studies / Primary care / Pulmonary functions / Questionnaires / Regression analysis / Research and Analysis Methods / Respiratory function / Respiratory Function Tests - methods / Respiratory system / Risk analysis / Risk factors / Rural areas / Rural Population - statistics & numerical data / Sex ratio / Sexually transmitted diseases / Social Sciences / South Africa - epidemiology / Spirometry / STD / Studies / Surveys and Questionnaires / Tuberculosis / Tuberculosis, Pulmonary - epidemiology / Tuberculosis, Pulmonary - microbiology / Tuberculosis, Pulmonary - physiopathology