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Association Between CD4+, Viral Load, and Pulmonary Function in HIV

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Abstract

Purpose

The antiretroviral therapy era has shifted the epidemiology of HIV-associated diseases, increasing the recognition of non-infectious pulmonary complications secondary to HIV. We aimed to determine the association between CD4+, viral load, and pulmonary function in individuals with uncontrolled HIV, and determine how changes in these parameters are associated with pulmonary function longitudinally.

Methods

This is a retrospective observational study of individuals with HIV who underwent pulmonary function testing in an urban medical center between August 1997 and November 2015.

Results

Of the 146 participants (mean age 52 ± 10 years), 49% were Hispanic, 56% were men, and 44% were current smokers. CD4+ <200 cells/μl was associated with significant diffusion impairment compared to CD4+ ≥200 cells/μl (DLCO 56 vs. 70%, p = <0.01). VL (viral load) ≥75 copies/ml was associated with significant diffusion impairment compared to VL <75 copies/ml (DLCO 60 vs. 71%, p = <0.01). No difference in FEV1, FEV1/FVC, or TLC was noted between groups. In univariate analysis, CD4+ and VL correlated with DLCO (r = +0.33; p = <0.01; r = −0.26; p = <0.01) and no correlation was noted with FEV1, FEV1/FVC, or TLC. Current smoking and history of AIDS correlated with DLCO (r = −0.20; p = 0.03; r = −0.20; p = 0.04). After adjusting for smoking and other confounders, VL ≥75 copies/ml correlated with a 11.2 (CI 95% [3.03–19.4], p = <0.01) decrease in DLCO. In Spearman’s Rank correlation, there was a negative correlation between change in VL and change in DLCO over time (ρ = −0.47; p = <0.01).

Conclusion

The presence of viremia in individuals with HIV is independently associated with impaired DLCO. Suppression of VL may allow for recovery in diffusing capacity over time, though the degree to which this occurs requires further investigation.

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Funding

There are no organizations that funded the research conducted for this scientific investigation. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Internal Medicine, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Marjan Islam, Samuel Kolman & Matthew Frank

  2. Division of Pulmonary, Critical Care and Sleep Medicine, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Marjan Islam, Navitha Ramesh, Albert Miller & Mary Harris

  3. Division of Infectious Diseases, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Sanjana Koshy & Nadim Salomon

Authors
  1. Marjan Islam
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  2. Navitha Ramesh
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  3. Samuel Kolman
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  4. Sanjana Koshy
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  5. Matthew Frank
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  6. Nadim Salomon
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  7. Albert Miller
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  8. Mary Harris
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Corresponding author

Correspondence to Marjan Islam.

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The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required. This article does not contain any studies with animals performed by any of the authors.

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Islam, M., Ramesh, N., Kolman, S. et al. Association Between CD4+, Viral Load, and Pulmonary Function in HIV. Lung 195, 635–642 (2017). https://doi.org/10.1007/s00408-017-0030-5

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  • DOI: https://doi.org/10.1007/s00408-017-0030-5

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