• Kristina Crothers, Kathleen McGinnis, Eric Kleerup, Cherry Wongtrakool, Guy S Hoo, Joon Kim, Amir Sharafkhaneh, Laurence Huang, Zhaoyu Luo, Bruce Thompson, Philip Diaz, Gregory D Kirk, William Rom, Roger Detels, Lawrence Kingsley, and Alison Morris.
• *Department of Medicine, University of Washington, Seattle, WA; †Department of Medicine, University of Pittsburgh, Pittsburgh, PA; ‡Department of Medicine, University of California, Los Angeles, Los Angeles, CA; §Department of Medicine, Atlanta Veterans Affairs Medical Center (VAMC) and Emory University, Atlanta, GA; ‖Department of Medicine, West Los Angeles VAMC and David Geffen School of Medicine at University of California Los Angeles (UCLA), Los Angeles, CA; ¶Department of Medicine, James J. Peters Bronx VAMC, Bronx, NY; #Department of Medicine, Michael E. DeBakey Houston VAMC and Baylor College of Medicine, Houston, TX; **Department of Medicine, University of California, San Francisco, San Francisco, CA; ††Department of Medicine, Clinical Trials and Survey Corporation, Owings Mills, MD; ‡‡Department of Medicine, Ohio State University Medical Center, Columbus, OH; §§Department of Medicine, Johns Hopkins University, Baltimore, MD; ‖‖Department of Medicine, New York University School of Medicine, New York, NY; ¶¶Departments of Infectious Diseases and Microbiology; and Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA; and ##Departments of Medicine and Immunology, University of Pittsburgh, Pittsburgh, PA.
• J. Acquir. Immune Defic. Syndr. 2013 Nov 1; 64 (3): 271-8.

IntroductionPrior studies comparing abnormalities in pulmonary function between HIV-infected and HIV-uninfected persons in the current era are limited.ObjectivesTo determine the pattern and severity of impairment in pulmonary function in HIV-infected compared with HIV-uninfected individuals.MethodsCross-sectional analysis of 300 HIV-infected men and 289 HIV-uninfected men enrolled from 2009 to 2011 in 2 clinical centers of the Lung HIV Study. Participants completed pre- and postbronchodilator spirometry, diffusing capacity of the lung for carbon monoxide (DLCO) measurement, and standardized questionnaires.ResultsMost participants had normal airflow; 18% of HIV-infected and 16% of HIV-uninfected men had airflow obstruction. The mean percent predicted DLCO was 69% in HIV-infected vs. 76% in HIV-uninfected men (P < 0.001). A moderately to severely reduced DLCO of ≤60% was observed in 30% of HIV-infected compared with 18% of HIV-uninfected men (P < 0.001), despite the fact that 89% of those with HIV were on antiretroviral therapy. A reduced DLCO was significantly associated with HIV and CD4 cell count in linear regression adjusting for smoking and other confounders. The DLCO was lowest in HIV-infected men with CD4 cell counts <200 cells per microliter compared with those with CD4 cell counts ≥200 cells per microliter and to HIV-uninfected men. Respiratory symptoms of cough, phlegm and dyspnea were more prevalent in HIV-infected patients particularly those with abnormal pulmonary function compared with HIV-uninfected patients.ConclusionsHIV infection is an independent risk factor for reduced DLCO, particularly in individuals with a CD4 cell count below 200 cells per microliter. Abnormalities in pulmonary function among HIV-infected patients manifest clinically with increased respiratory symptoms. Mechanisms accounting for the reduced DLCO require further evaluation.

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