PMID- 27716727
OWN - NLM
STAT- MEDLINE
DCOM- 20170612
LR  - 20200930
IS  - 1944-7884 (Electronic)
IS  - 1525-4135 (Print)
IS  - 1525-4135 (Linking)
VI  - 74
IP  - 1
DP  - 2017 Jan 1
TI  - The Differential Impact of Emphysema on Respiratory Symptoms and 6-Minute Walk 
      Distance in HIV Infection.
PG  - e23-e29
AB  - BACKGROUND: Emphysema is more prevalent in HIV-infected (HIV+) patients 
      independent of smoking behavior. Nonetheless, health effects of emphysema in this 
      population are poorly understood. We determined whether emphysema is associated 
      with a greater burden of pulmonary symptoms and a lower 6-minute walk distance 
      (6MWD) in HIV+ compared with HIV-uninfected (HIV-) subjects. METHODS: We 
      performed a cross-sectional analysis of 170 HIV+ and 153 HIV- subjects in the 
      Examinations of HIV-Associated Lung Emphysema (EXHALE) cohort study. Subjects 
      completed a self-assessment of respiratory symptoms, pulmonary function testing, 
      and 6MWD testing as well as a chest computed tomography to determine emphysema 
      severity. We used regression models to determine the association of emphysema 
      with respiratory symptoms and 6MWD in HIV+ subjects and compared this to HIV- 
      subjects. RESULTS: Models stratified by HIV status demonstrated an association 
      between >10% radiographic emphysema and chronic cough and/or phlegm and 6MWD in 
      HIV+ subjects. These associations persisted among the subset without airflow 
      obstruction: those with emphysema had 4.2 (95% confidence interval: 1.3 to 14) 
      times the odds of chronic cough and/or phlegm and walked 60 m (95% confidence 
      interval: 26 to 93) less distance than those without emphysema. There was no 
      association between >10% emphysema and symptoms or 6MWD in HIV- subjects. 
      CONCLUSIONS: In our cohort, >10% radiographic emphysema was associated with 
      chronic cough and/or phlegm and lower 6MWD in HIV+ but not HIV- subjects. These 
      findings were robust even among HIV+ subjects with milder forms of emphysema and 
      those without airflow obstruction, highlighting the clinical impact of emphysema 
      in these patients.
FAU - Triplette, Matthew
AU  - Triplette M
AD  - *Department of Medicine, University of Washington, Seattle, WA; daggerDepartment of 
      Internal Medicine, Veterans Affairs Connecticut Healthcare System, Yale 
      University School of Medicine, New Haven, CT; double daggerDepartment of Medicine, Michael E. 
      DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, Houston, TX; 
       section signDepartment of Radiology, University of Washington, Seattle, WA;  ||Department of 
      Medicine, Atlanta Veterans Affairs Medical Center, Emory University School of 
      Medicine, Atlanta, GA;  paragraph signDepartment of Medicine, Veterans Affairs Greater Los 
      Angeles Healthcare System, David Geffen School of Medicine at UCLA, Los Angeles, 
      CA; #Department of Medicine, James J. Peters Veterans Affairs Medical Center, 
      Bronx, NY; and **Department of Medicine, Icahn School of Medicine at Mt. Sinai, 
      New York, NY.
FAU - Attia, Engi
AU  - Attia E
FAU - Akgun, Kathleen
AU  - Akgun K
FAU - Campo, Monica
AU  - Campo M
FAU - Rodriguez-Barradas, Maria
AU  - Rodriguez-Barradas M
FAU - Pipavath, Sudhakar
AU  - Pipavath S
FAU - Shahrir, Shahida
AU  - Shahrir S
FAU - Wongtrakool, Cherry
AU  - Wongtrakool C
FAU - Goetz, Matthew
AU  - Goetz M
FAU - Kim, Joon
AU  - Kim J
FAU - Soo Hoo, Guy W
AU  - Soo Hoo GW
FAU - Brown, Sheldon T
AU  - Brown ST
FAU - Crothers, Kristina
AU  - Crothers K
LA  - eng
GR  - UL1 TR001863/TR/NCATS NIH HHS/United States
GR  - R01 HL090342/HL/NHLBI NIH HHS/United States
GR  - T32 HL007287/HL/NHLBI NIH HHS/United States
GR  - U01 AA020790/AA/NIAAA NIH HHS/United States
GR  - U01 AA013566/AA/NIAAA NIH HHS/United States
GR  - P30 AI027757/AI/NIAID NIH HHS/United States
GR  - U24 AA020794/AA/NIAAA NIH HHS/United States
PT  - Journal Article
PL  - United States
TA  - J Acquir Immune Defic Syndr
JT  - Journal of acquired immune deficiency syndromes (1999)
JID - 100892005
RN  - 0 (IMPACT protein, human)
RN  - 0 (Intracellular Signaling Peptides and Proteins)
RN  - 0 (Proteins)
SB  - IM
MH  - Cohort Studies
MH  - Cross-Sectional Studies
MH  - Emphysema/*complications
MH  - Female
MH  - HIV Infections/*complications
MH  - Humans
MH  - Intracellular Signaling Peptides and Proteins
MH  - *Locomotion
MH  - Male
MH  - Middle Aged
MH  - Proteins
MH  - Respiratory Insufficiency/*pathology
PMC - PMC5140705
MID - NIHMS800541
EDAT- 2016/10/08 06:00
MHDA- 2017/06/13 06:00
PMCR- 2018/01/01
CRDT- 2016/10/08 06:00
PHST- 2016/10/08 06:00 [pubmed]
PHST- 2017/06/13 06:00 [medline]
PHST- 2016/10/08 06:00 [entrez]
PHST- 2018/01/01 00:00 [pmc-release]
AID - 10.1097/QAI.0000000000001133 [doi]
PST - ppublish
SO  - J Acquir Immune Defic Syndr. 2017 Jan 1;74(1):e23-e29. doi: 
      10.1097/QAI.0000000000001133.