BACKGROUND: People with HIV (PWH) have a higher burden of respiratory comorbidities than the general population, yet emerging spirometry impairments such as preserved ratio impaired spirometry (PRISm) and restrictive spirometry patterns (RSP) have received limited attention. RESEARCH QUESTION: Is HIV status associated with PRISm and RSP in well-treated PWH residing in high-income settings? STUDY DESIGN AND METHODS: /FVC ≥ LLN and FVC < LLN. We used multivariable logistic regression analyses and adjusted for HIV-specific and traditional risk factors. RESULTS: The prevalence of PRISm and RSP was higher among PWH compared with population controls (PRISm: 10.5% (95%CI, 8.8-12.4) vs. 3.5% (95%CI, 3.2-3.8), P<0.01; RSP: 10.6% (95%CI, 8,9-12.6) vs. 3.2% (95%CI, 2.9-3.5); P <0.01). These differences persisted in analyses restricted to persons that never smoked. HIV was associated with PRISm and RSP in univariable analyses, in models adjusted for age, sex, smoking status, body mass index and educational level (PRISm: OR, 3.58; 95%CI, 2.77-4.63. RSP: OR, 4.55; 95%CI, 3.51-5.91), and in fully adjusted models with alcohol consumption, diabetes, and hypertension (PRISm: OR, 3.40; 95%CI 2.59-4.47. RSP: OR, 4.34; 95%CI 3.29-5.73). PWH with PRISm or RSP had a higher burden of respiratory symptoms compared to those without. INTERPRETATION: PWH had three-fold higher prevalences of PRISm and RSP compared with population controls, and HIV was independently associated with these lung function impairments. PRISm and RSP may represent distinct manifestations of HIV-associated lung function impairment.
Heidari et al. (Mon,) studied this question.