Evaluation of Functional Respiratory Parameters in AIDS Patients Assisted in the Infectious Diseases Ambulatory Care Clinic of a Tertiary Care University Hospital in Brazil

Abstract

Pulmonary function, in HIV infected patients, has been associated with reduction in pulmonary ventilation parameters. We conducted a prospective cross sectional study to evaluate the pulmonary function of AIDS patients cared for in the infectious diseases ambulatory care clinic. Maximal inspiratory (P(Imax)) and expiratory (P(Emax)) pressures and spirometry were assessed. Clinical, demographic, and laboratory data were also evaluated. P(Imax) and P(Emax) were assessed in 73 and spirometry in 54 subjects. The mean time of HIV infection (in years) was similar for men (8.5 ± 5.1 y) and women (10.4 ± 4.2 y, P = .13), and the mean time of use of antiretroviral therapy was 8.5 ± 4.1 years for women and 7.7 ± 4.1 years for men (P = .46). P(Imax) and P(Emax) values were normal in 35 (48%) and 48 (66%) subjects, respectively. The use of tenofovir and presence of cough, by the time the test was performed, were independently associated with P(Emax) below the predicted value. Elevated creatine kinase values were associated with prolonged antiretroviral usage (9.6 ± 4.1 y vs 7.4 ± 3.9 y, P = .05). FVC was reduced in 14 (26.4%) subjects and was independently associated with high and/or intermediate cardiovascular risk (P = .002), and those with reduced vesicular murmur in auscultation (P = .047). FEV(1) was significantly lower in subjects with prolonged time of smoking (P = .02) and high and/or intermediate cardiovascular risk (P = .003). Reduced FEV(1)/FVC was associated with smoking (P = .041). AIDS subjects, in our study, had reduced parameters of maximal respiratory pressures and spirometry. The frequent dysfunction of respiratory muscles might be due to the association of multiple factors and not a particular one; moreover, smoking was independently associated with abnormal airway function. Pulmonary function tests should be implemented as an essential part of the medical assistance to AIDS patients.