PMID- 36737697
OWN - NLM
STAT- MEDLINE
DCOM- 20230207
LR  - 20240411
IS  - 1471-2466 (Electronic)
IS  - 1471-2466 (Linking)
VI  - 23
IP  - 1
DP  - 2023 Feb 3
TI  - Lung function and collagen 1a levels are associated with changes in 6 min walk 
      test distance during treatment of TB among HIV-infected adults: a prospective 
      cohort study.
PG  - 53
LID - 10.1186/s12890-023-02325-7 [doi]
LID - 53
AB  - BACKGROUND: Patients with tuberculosis (TB) and HIV often present with 
      impairments in lung function and exercise capacity after treatment. We evaluated 
      clinical and immunologic variables associated with a minimum clinically important 
      difference (MCID) in the change in the 6 min walk test distance during the first 
      24 weeks of antiretroviral (ART) and anti-tubercular therapy. METHODS: Adults 
      initiating ART and anti-TB treatment in the setting of newly-diagnosed HIV and 
      pulmonary TB were enrolled in a prospective cohort study in South Africa. 
      Patients underwent 6 min walk tests and spirometry at weeks 0, 4, 12, and 24 and 
      biomarker level measurements early during treatment, at weeks 0, 4, and 12, when 
      inflammation levels are typically elevated. Biomarkers included matrix 
      metalloproteinases-1 (MMP-1), tissue inhibitor of MMP (TIMP)-1, collagen 1a, 
      IL-6, IL-8, vascular cell adhesion molecule 1 (VCAM-1), C-X-C motif chemokine 10 
      (CXCL-10), CXCL-11, macrophage colony-stimulating factor (M-CSF), plasminogen 
      activator, vascular endothelial growth factor, and chemokine (C-C) motif-2 
      (CCL-2). An MCID was derived statistically, and achievement of an MCID was 
      modeled as the outcome using logistic regression model. RESULTS: Eighty-nine 
      patients walked an average of 393 (+/- standard deviation = 69) meters at baseline, 
      which increased by an average of 9% (430 +/- 70 m) at week 24. The MCID for change 
      in walk distance was estimated as 41 m. Patients experiencing an MCID on 
      treatment had worse lung function, lower 6 min walk test distance, higher levels 
      of proinflammatory biomarkers including TIMP-1 and M-CSF, and lower levels of 
      collagen 1a at baseline. Experiencing an MCID during treatment was associated 
      with increases in forced expiratory volume in 1-s [odds ratio (OR) = 1.17, 95% 
      confidence interval (CI) = 1.05-1.33] and increases in blood collagen 1a levels 
      (OR = 1.31, 95%CI 1.06-1.62). CONCLUSIONS: ART and TB treatment are associated 
      with substantial improvements in 6 min walk test distance over time. Achievement 
      of an MCID in the 6 min walk test in this study was associated with more severe 
      disease at baseline and increases in collagen 1a levels and lung function during 
      therapy.
CI  - (c) 2023. The Author(s).
FAU - Baik, Yeonsoo
AU  - Baik Y
AD  - Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical 
      Epidemiology and Biostatistics, Perelman School of Medicine at the University of 
      Pennsylvania, 832 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 
      19104-6021, USA.
FAU - Maenetje, Pholo
AU  - Maenetje P
AD  - The Aurum Institute, Johannesburg, South Africa.
FAU - Schramm, Diana
AU  - Schramm D
AD  - Department of Virology, Faculty of Health Sciences, School of Pathology, 
      University of the Witwatersrand, Johannesburg, South Africa.
AD  - Centre for HIV and STIs, National Institute for Communicable Diseases, 
      Johannesburg, South Africa.
FAU - Tiemessen, Caroline
AU  - Tiemessen C
AD  - Department of Virology, Faculty of Health Sciences, School of Pathology, 
      University of the Witwatersrand, Johannesburg, South Africa.
AD  - Centre for HIV and STIs, National Institute for Communicable Diseases, 
      Johannesburg, South Africa.
FAU - Ncube, Itai
AU  - Ncube I
AD  - The Aurum Institute, Johannesburg, South Africa.
FAU - Churchyard, Gavin
AU  - Churchyard G
AD  - The Aurum Institute, Johannesburg, South Africa.
AD  - School of Public Health, University of Witwatersrand, Johannesburg, South Africa.
FAU - Wallis, Robert
AU  - Wallis R
AD  - The Aurum Institute, Johannesburg, South Africa.
FAU - Vangu, Mboyo-di-Tamba
AU  - Vangu MD
AD  - Department of Nuclear Medicine, CM Johannesburg Academic Hospital, University of 
      the Witwatersrand, Johannesburg, South Africa.
FAU - Kornfeld, Hardy
AU  - Kornfeld H
AD  - Department of Medicine, University of Massachusetts Chan Medical School, 
      Worcester, USA.
FAU - Li, Yun
AU  - Li Y
AD  - Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical 
      Epidemiology and Biostatistics, Perelman School of Medicine at the University of 
      Pennsylvania, 832 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 
      19104-6021, USA.
FAU - Auld, Sara C
AU  - Auld SC
AD  - Department of Medicine, Emory University Rollins School of Public Health and 
      School of Medicine, Atlanta, GA, USA.
FAU - Bisson, Gregory P
AU  - Bisson GP
AD  - Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical 
      Epidemiology and Biostatistics, Perelman School of Medicine at the University of 
      Pennsylvania, 832 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 
      19104-6021, USA. bisson@pennmedicine.upenn.edu.
AD  - Division of Infectious Diseases, Department of Medicine, Perelman School of 
      Medicine at the University of Pennsylvania, Philadelphia, PA, USA. 
      bisson@pennmedicine.upenn.edu.
LA  - eng
GR  - P30 AI050409/AI/NIAID NIH HHS/United States
GR  - P30AI04500823/NH/NIH HHS/United States
GR  - R01AI120821/NH/NIH HHS/United States
PT  - Journal Article
DEP - 20230203
PL  - England
TA  - BMC Pulm Med
JT  - BMC pulmonary medicine
JID - 100968563
RN  - 81627-83-0 (Macrophage Colony-Stimulating Factor)
RN  - 0 (Vascular Endothelial Growth Factor A)
RN  - 0 (Biomarkers)
SB  - IM
MH  - Humans
MH  - Adult
MH  - Walk Test
MH  - Macrophage Colony-Stimulating Factor/therapeutic use
MH  - Prospective Studies
MH  - Vascular Endothelial Growth Factor A/therapeutic use
MH  - *Tuberculosis/complications
MH  - Biomarkers
MH  - Lung
MH  - *HIV Infections/complications/drug therapy
PMC - PMC9896708
OTO - NOTNLM
OT  - HIV/TB
OT  - Inflammatory biomarkers
OT  - Post-treatment
OT  - Six-minute walk test
OT  - Tuberculosis
COIS- The authors declare that they have no competing interests.
EDAT- 2023/02/05 06:00
MHDA- 2023/02/08 06:00
PMCR- 2023/02/03
CRDT- 2023/02/04 00:02
PHST- 2022/05/17 00:00 [received]
PHST- 2023/01/13 00:00 [accepted]
PHST- 2023/02/04 00:02 [entrez]
PHST- 2023/02/05 06:00 [pubmed]
PHST- 2023/02/08 06:00 [medline]
PHST- 2023/02/03 00:00 [pmc-release]
AID - 10.1186/s12890-023-02325-7 [pii]
AID - 2325 [pii]
AID - 10.1186/s12890-023-02325-7 [doi]
PST - epublish
SO  - BMC Pulm Med. 2023 Feb 3;23(1):53. doi: 10.1186/s12890-023-02325-7.