Emphysema Distribution and Diffusion Capacity Predict Emphysema Progression in Human Immunodeficiency Virus Infection.
Chronic obstructive pulmonary disease (COPD) and emphysema are common amongst patients with human immunodeficiency virus (HIV). We sought to determine the clinical factors that are associated with emphysema progression in HIV.345 HIV-infected patients enrolled in an outpatient HIV metabolic clinic w...
Main Authors: | , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Public Library of Science (PLoS)
2016-01-01
|
Series: | PLoS ONE |
Online Access: | http://europepmc.org/articles/PMC5130231?pdf=render |
id |
doaj-05c4a7f41bcf49cb8838f0db350ae112 |
---|---|
record_format |
Article |
spelling |
doaj-05c4a7f41bcf49cb8838f0db350ae1122020-11-25T00:08:37ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-011111e016724710.1371/journal.pone.0167247Emphysema Distribution and Diffusion Capacity Predict Emphysema Progression in Human Immunodeficiency Virus Infection.Janice M LeungAndrea MalagoliAntonella SantoroGiulia BesuttiGuido LigabueRiccardo ScaglioniDarlene DaiCameron HagueJonathon LeipsicDon D SinSf Paul ManGiovanni GuaraldiChronic obstructive pulmonary disease (COPD) and emphysema are common amongst patients with human immunodeficiency virus (HIV). We sought to determine the clinical factors that are associated with emphysema progression in HIV.345 HIV-infected patients enrolled in an outpatient HIV metabolic clinic with ≥2 chest computed tomography scans made up the study cohort. Images were qualitatively scored for emphysema based on percentage involvement of the lung. Emphysema progression was defined as any increase in emphysema score over the study period. Univariate analyses of clinical, respiratory, and laboratory data, as well as multivariable logistic regression models, were performed to determine clinical features significantly associated with emphysema progression.17.4% of the cohort were emphysema progressors. Emphysema progression was most strongly associated with having a low baseline diffusion capacity of carbon monoxide (DLCO) and having combination centrilobular and paraseptal emphysema distribution. In adjusted models, the odds ratio (OR) for emphysema progression for every 10% increase in DLCO percent predicted was 0.58 (95% confidence interval [CI] 0.41-0.81). The equivalent OR (95% CI) for centrilobular and paraseptal emphysema distribution was 10.60 (2.93-48.98). Together, these variables had an area under the curve (AUC) statistic of 0.85 for predicting emphysema progression. This was an improvement over the performance of spirometry (forced expiratory volume in 1 second to forced vital capacity ratio), which predicted emphysema progression with an AUC of only 0.65.Combined paraseptal and centrilobular emphysema distribution and low DLCO could identify HIV patients who may experience emphysema progression.http://europepmc.org/articles/PMC5130231?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Janice M Leung Andrea Malagoli Antonella Santoro Giulia Besutti Guido Ligabue Riccardo Scaglioni Darlene Dai Cameron Hague Jonathon Leipsic Don D Sin Sf Paul Man Giovanni Guaraldi |
spellingShingle |
Janice M Leung Andrea Malagoli Antonella Santoro Giulia Besutti Guido Ligabue Riccardo Scaglioni Darlene Dai Cameron Hague Jonathon Leipsic Don D Sin Sf Paul Man Giovanni Guaraldi Emphysema Distribution and Diffusion Capacity Predict Emphysema Progression in Human Immunodeficiency Virus Infection. PLoS ONE |
author_facet |
Janice M Leung Andrea Malagoli Antonella Santoro Giulia Besutti Guido Ligabue Riccardo Scaglioni Darlene Dai Cameron Hague Jonathon Leipsic Don D Sin Sf Paul Man Giovanni Guaraldi |
author_sort |
Janice M Leung |
title |
Emphysema Distribution and Diffusion Capacity Predict Emphysema Progression in Human Immunodeficiency Virus Infection. |
title_short |
Emphysema Distribution and Diffusion Capacity Predict Emphysema Progression in Human Immunodeficiency Virus Infection. |
title_full |
Emphysema Distribution and Diffusion Capacity Predict Emphysema Progression in Human Immunodeficiency Virus Infection. |
title_fullStr |
Emphysema Distribution and Diffusion Capacity Predict Emphysema Progression in Human Immunodeficiency Virus Infection. |
title_full_unstemmed |
Emphysema Distribution and Diffusion Capacity Predict Emphysema Progression in Human Immunodeficiency Virus Infection. |
title_sort |
emphysema distribution and diffusion capacity predict emphysema progression in human immunodeficiency virus infection. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2016-01-01 |
description |
Chronic obstructive pulmonary disease (COPD) and emphysema are common amongst patients with human immunodeficiency virus (HIV). We sought to determine the clinical factors that are associated with emphysema progression in HIV.345 HIV-infected patients enrolled in an outpatient HIV metabolic clinic with ≥2 chest computed tomography scans made up the study cohort. Images were qualitatively scored for emphysema based on percentage involvement of the lung. Emphysema progression was defined as any increase in emphysema score over the study period. Univariate analyses of clinical, respiratory, and laboratory data, as well as multivariable logistic regression models, were performed to determine clinical features significantly associated with emphysema progression.17.4% of the cohort were emphysema progressors. Emphysema progression was most strongly associated with having a low baseline diffusion capacity of carbon monoxide (DLCO) and having combination centrilobular and paraseptal emphysema distribution. In adjusted models, the odds ratio (OR) for emphysema progression for every 10% increase in DLCO percent predicted was 0.58 (95% confidence interval [CI] 0.41-0.81). The equivalent OR (95% CI) for centrilobular and paraseptal emphysema distribution was 10.60 (2.93-48.98). Together, these variables had an area under the curve (AUC) statistic of 0.85 for predicting emphysema progression. This was an improvement over the performance of spirometry (forced expiratory volume in 1 second to forced vital capacity ratio), which predicted emphysema progression with an AUC of only 0.65.Combined paraseptal and centrilobular emphysema distribution and low DLCO could identify HIV patients who may experience emphysema progression. |
url |
http://europepmc.org/articles/PMC5130231?pdf=render |
work_keys_str_mv |
AT janicemleung emphysemadistributionanddiffusioncapacitypredictemphysemaprogressioninhumanimmunodeficiencyvirusinfection AT andreamalagoli emphysemadistributionanddiffusioncapacitypredictemphysemaprogressioninhumanimmunodeficiencyvirusinfection AT antonellasantoro emphysemadistributionanddiffusioncapacitypredictemphysemaprogressioninhumanimmunodeficiencyvirusinfection AT giuliabesutti emphysemadistributionanddiffusioncapacitypredictemphysemaprogressioninhumanimmunodeficiencyvirusinfection AT guidoligabue emphysemadistributionanddiffusioncapacitypredictemphysemaprogressioninhumanimmunodeficiencyvirusinfection AT riccardoscaglioni emphysemadistributionanddiffusioncapacitypredictemphysemaprogressioninhumanimmunodeficiencyvirusinfection AT darlenedai emphysemadistributionanddiffusioncapacitypredictemphysemaprogressioninhumanimmunodeficiencyvirusinfection AT cameronhague emphysemadistributionanddiffusioncapacitypredictemphysemaprogressioninhumanimmunodeficiencyvirusinfection AT jonathonleipsic emphysemadistributionanddiffusioncapacitypredictemphysemaprogressioninhumanimmunodeficiencyvirusinfection AT dondsin emphysemadistributionanddiffusioncapacitypredictemphysemaprogressioninhumanimmunodeficiencyvirusinfection AT sfpaulman emphysemadistributionanddiffusioncapacitypredictemphysemaprogressioninhumanimmunodeficiencyvirusinfection AT giovanniguaraldi emphysemadistributionanddiffusioncapacitypredictemphysemaprogressioninhumanimmunodeficiencyvirusinfection |
_version_ |
1725415457003929600 |