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

• Published in: PloS one 2019-01, Vol.14 (1), p.e0210573-e0210573
• Main Authors: Varkila, Meri R J, Vos, Alinda G, Barth, Roos E, Tempelman, Hugo A, Devillé, Walter L J, Coutinho, Roel A, Grobbee, Diederick E, Klipstein-Grobusch, Kerstin
• Format: Article
• Language: English
• Subjects: 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
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0210573

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.