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Emphysema Distribution and Diffusion Capacity Predict Emphysema Progression in Human Immunodeficiency Virus Infection

BACKGROUND: Chronic obstructive pulmonary disease (COPD) and emphysema are common amongst patients with human immunodeficiency virus (HIV). We sought to determine the clinical factors that are associated with emphysema progression in HIV. METHODS: 345 HIV-infected patients enrolled in an outpatient...

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Autores principales: Leung, Janice M, Malagoli, Andrea, Santoro, Antonella, Besutti, Giulia, Ligabue, Guido, Scaglioni, Riccardo, Dai, Darlene, Hague, Cameron, Leipsic, Jonathon, Sin, Don D., Man, SF Paul, Guaraldi, Giovanni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5130231/
https://www.ncbi.nlm.nih.gov/pubmed/27902753
http://dx.doi.org/10.1371/journal.pone.0167247
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author Leung, Janice M
Malagoli, Andrea
Santoro, Antonella
Besutti, Giulia
Ligabue, Guido
Scaglioni, Riccardo
Dai, Darlene
Hague, Cameron
Leipsic, Jonathon
Sin, Don D.
Man, SF Paul
Guaraldi, Giovanni
author_facet Leung, Janice M
Malagoli, Andrea
Santoro, Antonella
Besutti, Giulia
Ligabue, Guido
Scaglioni, Riccardo
Dai, Darlene
Hague, Cameron
Leipsic, Jonathon
Sin, Don D.
Man, SF Paul
Guaraldi, Giovanni
author_sort Leung, Janice M
collection PubMed
description BACKGROUND: Chronic obstructive pulmonary disease (COPD) and emphysema are common amongst patients with human immunodeficiency virus (HIV). We sought to determine the clinical factors that are associated with emphysema progression in HIV. METHODS: 345 HIV-infected patients enrolled in an outpatient HIV metabolic clinic with ≥2 chest computed tomography scans made up the study cohort. Images were qualitatively scored for emphysema based on percentage involvement of the lung. Emphysema progression was defined as any increase in emphysema score over the study period. Univariate analyses of clinical, respiratory, and laboratory data, as well as multivariable logistic regression models, were performed to determine clinical features significantly associated with emphysema progression. RESULTS: 17.4% of the cohort were emphysema progressors. Emphysema progression was most strongly associated with having a low baseline diffusion capacity of carbon monoxide (DLCO) and having combination centrilobular and paraseptal emphysema distribution. In adjusted models, the odds ratio (OR) for emphysema progression for every 10% increase in DLCO percent predicted was 0.58 (95% confidence interval [CI] 0.41–0.81). The equivalent OR (95% CI) for centrilobular and paraseptal emphysema distribution was 10.60 (2.93–48.98). Together, these variables had an area under the curve (AUC) statistic of 0.85 for predicting emphysema progression. This was an improvement over the performance of spirometry (forced expiratory volume in 1 second to forced vital capacity ratio), which predicted emphysema progression with an AUC of only 0.65. CONCLUSION: Combined paraseptal and centrilobular emphysema distribution and low DLCO could identify HIV patients who may experience emphysema progression.
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spelling pubmed-51302312016-12-15 Emphysema Distribution and Diffusion Capacity Predict Emphysema Progression in Human Immunodeficiency Virus Infection Leung, Janice M Malagoli, Andrea Santoro, Antonella Besutti, Giulia Ligabue, Guido Scaglioni, Riccardo Dai, Darlene Hague, Cameron Leipsic, Jonathon Sin, Don D. Man, SF Paul Guaraldi, Giovanni PLoS One Research Article BACKGROUND: Chronic obstructive pulmonary disease (COPD) and emphysema are common amongst patients with human immunodeficiency virus (HIV). We sought to determine the clinical factors that are associated with emphysema progression in HIV. METHODS: 345 HIV-infected patients enrolled in an outpatient HIV metabolic clinic with ≥2 chest computed tomography scans made up the study cohort. Images were qualitatively scored for emphysema based on percentage involvement of the lung. Emphysema progression was defined as any increase in emphysema score over the study period. Univariate analyses of clinical, respiratory, and laboratory data, as well as multivariable logistic regression models, were performed to determine clinical features significantly associated with emphysema progression. RESULTS: 17.4% of the cohort were emphysema progressors. Emphysema progression was most strongly associated with having a low baseline diffusion capacity of carbon monoxide (DLCO) and having combination centrilobular and paraseptal emphysema distribution. In adjusted models, the odds ratio (OR) for emphysema progression for every 10% increase in DLCO percent predicted was 0.58 (95% confidence interval [CI] 0.41–0.81). The equivalent OR (95% CI) for centrilobular and paraseptal emphysema distribution was 10.60 (2.93–48.98). Together, these variables had an area under the curve (AUC) statistic of 0.85 for predicting emphysema progression. This was an improvement over the performance of spirometry (forced expiratory volume in 1 second to forced vital capacity ratio), which predicted emphysema progression with an AUC of only 0.65. CONCLUSION: Combined paraseptal and centrilobular emphysema distribution and low DLCO could identify HIV patients who may experience emphysema progression. Public Library of Science 2016-11-30 /pmc/articles/PMC5130231/ /pubmed/27902753 http://dx.doi.org/10.1371/journal.pone.0167247 Text en © 2016 Leung et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Leung, Janice M
Malagoli, Andrea
Santoro, Antonella
Besutti, Giulia
Ligabue, Guido
Scaglioni, Riccardo
Dai, Darlene
Hague, Cameron
Leipsic, Jonathon
Sin, Don D.
Man, SF Paul
Guaraldi, Giovanni
Emphysema Distribution and Diffusion Capacity Predict Emphysema Progression in Human Immunodeficiency Virus Infection
title Emphysema Distribution and Diffusion Capacity Predict Emphysema Progression in Human Immunodeficiency Virus Infection
title_full Emphysema Distribution and Diffusion Capacity Predict Emphysema Progression in Human Immunodeficiency Virus Infection
title_fullStr Emphysema Distribution and Diffusion Capacity Predict Emphysema Progression in Human Immunodeficiency Virus Infection
title_full_unstemmed Emphysema Distribution and Diffusion Capacity Predict Emphysema Progression in Human Immunodeficiency Virus Infection
title_short Emphysema Distribution and Diffusion Capacity Predict Emphysema Progression in Human Immunodeficiency Virus Infection
title_sort emphysema distribution and diffusion capacity predict emphysema progression in human immunodeficiency virus infection
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5130231/
https://www.ncbi.nlm.nih.gov/pubmed/27902753
http://dx.doi.org/10.1371/journal.pone.0167247
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