Permanent declines in pulmonary function following pneumonia in human immunodeficiency virus-infected persons
Permanent declines in pulmonary function following pneumonia in human immunodeficiency virus-infected persons
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DOI：
10.1164/ajrccm.162.2.9912058
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发表时间：
2000-08-01
影响因子：
24.7
通讯作者：
Stansell, JD
中科院分区：
文献类型：
--
作者：
Morris, AM;Huang, L;Stansell, JD
人类免疫缺陷病毒(HIV)相关的呼吸道感染，最明显的是卡氏肺孢子虫肺炎(PCP)，但也有细菌性肺炎(BP)，导致主要在急性感染过程中研究的肺功能下降。艾滋病毒相关肺炎是否也会导致肺功能的永久性变化尚不清楚。在这项研究中，我们调查了PCP和BP对HIV感染者队列中肺功能的长期影响。美国6个中心对1,149名艾滋病毒感染者进行了前瞻性、观察性的队列研究。研究参与者每隔一段时间定期进行肺功能测试。PCP和BP的诊断通过定义的标准进行验证。根据人口学数据和PCP或BP的发生情况，使用纵向多变量分析对肺功能进行建模。我们发现PCP或BP与FEV1、FVC、FEV1/FVC和一氧化碳弥散能力的永久性降低有关。两种感染均未导致TLC有统计学意义的变化。我们得出结论，PCP和BP导致呼气气流减少，并在急性感染缓解后持续存在。这些变化的临床影响尚不清楚，但它们可能会导致患有肺炎的艾滋病毒感染患者的呼吸道症状延长。
Human immunodeficiency virus (HIV)-associated respiratory infections, most notably Pneumocystis carinii pneumonia (PCP), but also bacterial pneumonia (BP), result in reductions in lung function that have been studied mainly during the course of acute infection. Whether HIV-associated pneumonias also cause permanent changes in pulmonary function is unknown. In this study we investigated the long-term effects of PCP and BP on pulmonary function in a cohort of HIV-infected persons. One thousand, one hundred forty-nine HIV-infected persons were followed in a prospective, observational cohort study at six centers in the United States. Study participants had pulmonary function testing performed at regular preset intervals. PCP and BP diagnoses were verified with defined criteria. Longitudinal multivariate analysis was used to model pulmonary function in terms of demographic data and occurrence of PCP or BP. We found that PCP or BP was associated with permanent decreases in FEV1, FVC, FEV1/FVC, and the diffusing capacity of carbon monoxide. Neither infection resulted in statistically significant changes in TLC. We conclude that PCP and BP result in expiratory airflow reductions that persist after the acute infection resolves. The clinical implications of these changes are unknown, but they may contribute to prolonged respiratory complaints in HIV-infected patients who have had pneumonia.