HIV infection is an independent risk factor for decreased 6-minute walk test distance

• Published in: PloS one 2019-04, Vol.14 (4), p.e0212975-e0212975
• Main Authors: Robertson, Tom E, Nouraie, Mehdi, Qin, Shulin, Crothers, Kristina A, Kessinger, Cathy J, McMahon, Deborah, Chandra, Divay, Kingsley, Lawrence A, Greenblatt, Ruth M, Huang, Laurence, Fitzpatrick, Meghan E, Morris, Alison
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adult; AIDS; Air flow; Antiretroviral drugs; Carbon monoxide; Carbon Monoxide - chemistry; Chronic obstructive pulmonary disease; Comorbidity; Complications and side effects; Critical care; Diagnostic Tests, Routine; Disabilities; Drug therapy; Exercise; Female; Health aspects; Health risks; HIV; HIV - pathogenicity; HIV infections; HIV Infections - diagnosis; HIV Infections - epidemiology; HIV Infections - physiopathology; HIV Infections - virology; Human immunodeficiency virus; Humans; Infections; Infectious diseases; Lung - physiopathology; Lung - virology; Lung volume measurement; Male; Measuring instruments; Medical screening; Medicine; Methods; Middle Aged; Morbidity; Mortality; Physical fitness; Public health; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - epidemiology; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - virology; Quality of life; Regression analysis; Respiratory symptoms; Risk analysis; Risk Factors; Signs and symptoms; Smoking; Smoking - adverse effects; Spirometry; Studies; Surveys and Questionnaires; Thoracic surgery; Vital Capacity - physiology; Walk Test
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0212975

Ambulatory function predicts morbidity and mortality and may be influenced by cardiopulmonary dysfunction. Persons living with HIV (PLWH) suffer from a high prevalence of cardiac and pulmonary comorbidities that may contribute to higher risk of ambulatory dysfunction as measured by 6-minute walk test distance (6-MWD). We investigated the effect of HIV on 6-MWD. PLWH and HIV-uninfected individuals were enrolled from 2 clinical centers and completed a 6-MWD, spirometry, diffusing capacity for carbon monoxide (DLCO) and St. George's Respiratory Questionnaire (SGRQ). Results of 6-MWD were compared between PLWH and uninfected individuals after adjusting for confounders. Multivariable linear regression analysis was used to determine predictors of 6-MWD. Mean 6-MWD in PLWH was 431 meters versus 462 in 130 HIV-uninfected individuals (p = 0.0001). Older age, lower forced expiratory volume (FEV1)% or lower forced vital capacity (FVC)%, and smoking were significant predictors of decreased 6-MWD in PLWH, but not HIV-uninfected individuals. Lower DLCO% and higher SGRQ were associated with lower 6-MWD in both groups. In a combined model, HIV status remained an independent predictor of decreased 6-MWD (Mean difference = -19.9 meters, p = 0.005). HIV infection was associated with decreased ambulatory function. Airflow limitation and impaired diffusion capacity can partially explain this effect. Subjective assessments of respiratory symptoms may identify individuals at risk for impaired physical function who may benefit from early intervention.