Abstract | BACKGROUND: METHODS: In this prospective cohort study conducted in South Africa, we enrolled adults newly diagnosed with HIV and tuberculosis who were initiating antiretroviral therapy and tuberculosis treatment. We measured lung function and symptoms at baseline, 6, and 12 months. We compared participants with and without pulmonary impairment and constructed logistic regression models to identify characteristics associated with pulmonary impairment. RESULTS: Among 134 participants with a median CD4 count of 110 cells/μl, 112 (83%) completed baseline spirometry at which time 32 (29%) had restriction, 13 (12%) had obstruction, and 9 (7%) had a mixed pattern. Lung function was dynamic over time and 30 (33%) participants had impaired lung function at 12 months. Baseline restriction was associated with greater symptoms and with long-term pulmonary impairment (adjusted odds ratio 5.44, 95% confidence interval 1.16-25.45), while baseline obstruction was not (adjusted odds ratio 1.95, 95% confidence interval 0.28-13.78). CONCLUSIONS: In this cohort of people with HIV and tuberculosis, restriction was the most common, symptomatic, and persistent pattern of pulmonary impairment. These data can help to raise awareness among clinicians about the heterogeneity of post- tuberculosis pulmonary impairment, and highlight the need for further research into mediators of lung injury in this vulnerable population.
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Authors | Sara C Auld, Hardy Kornfeld, Pholo Maenetje, Mandla Mlotshwa, William Chase, Mboyo di-Tamba Vangu, Drew A Torigian, Robert S Wallis, Gavin Churchyard, Gregory P Bisson |
Journal | BMC pulmonary medicine
(BMC Pulm Med)
Vol. 21
Issue 1
Pg. 19
(Jan 07 2021)
ISSN: 1471-2466 [Electronic] England |
PMID | 33413293
(Publication Type: Journal Article)
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Chemical References |
- Anti-HIV Agents
- Antitubercular Agents
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Topics |
- Adult
- Anti-HIV Agents
(therapeutic use)
- Antitubercular Agents
(therapeutic use)
- CD4 Lymphocyte Count
- Cohort Studies
- Female
- Forced Expiratory Volume
(physiology)
- HIV Infections
(complications, drug therapy, physiopathology)
- Humans
- Lung
(physiopathology)
- Lung Diseases, Obstructive
(physiopathology)
- Male
- Prospective Studies
- South Africa
- Spirometry
- Tuberculosis, Pulmonary
(complications, drug therapy, physiopathology)
- Vital Capacity
(physiology)
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