Pulmonary restriction predicts long-term pulmonary impairment in people with HIV and tuberculosis.
Pulmonary restriction predicts long-term pulmonary impairment in people with HIV and tuberculosis.
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DOI：
10.1186/s12890-020-01368-4
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发表时间：
2021-01-07
影响因子：
3.1
通讯作者：
Bisson GP
中科院分区：
文献类型：
--
作者：
Auld SC;Kornfeld H;Maenetje P;Mlotshwa M;Chase W;Vangu MD;Torigian DA;Wallis RS;Churchyard G;Bisson GP
虽然结核病被认为是慢性阻塞性肺疾病的一个危险因素，但限制性肺损伤模式实际上可能在结核病幸存者中更常见。我们的目的是确定艾滋病毒感染者和结核病患者治疗前后肺功能损害的性质，并确定长期损害的危险因素。 在这项在南非进行的前瞻性队列研究中，我们招募了新诊断为艾滋病毒和结核病的成年人，他们正在开始抗逆转录病毒治疗和结核病治疗。我们测量了基线、6个月和12个月时的肺功能和症状。我们比较了有和没有肺损伤的参与者，并构建了逻辑回归模型，以确定与肺损伤相关的特征。 在134例中位CD 4计数为110个细胞/μl的受试者中，112例（83%）完成了基线肺功能测定，其中32例（29%）出现限制，13例（12%）出现阻塞，9例（7%）出现混合模式。肺功能随着时间的推移而变化，30名（33%）参与者在12个月时肺功能受损。基线限制与更严重的症状和长期肺功能损害相关（校正比值比5.44，95%置信区间1.16-25.45），而基线阻塞与此无关（校正比值比1.95，95%置信区间0.28-13.78）。 在这组艾滋病毒和结核病患者中，限制是最常见、最有症状和最持久的肺功能损害模式。这些数据有助于提高临床医生对结核病后肺损伤异质性的认识，并强调需要进一步研究这一脆弱人群中肺损伤的介质。
While tuberculosis is considered a risk factor for chronic obstructive pulmonary disease, a restrictive pattern of pulmonary impairment may actually be more common among tuberculosis survivors. We aimed to determine the nature of pulmonary impairment before and after treatment among people with HIV and tuberculosis and identify risk factors for long-term impairment. In this prospective cohort study conducted in South Africa, we enrolled adults newly diagnosed with HIV and tuberculosis who were initiating antiretroviral therapy and tuberculosis treatment. We measured lung function and symptoms at baseline, 6, and 12 months. We compared participants with and without pulmonary impairment and constructed logistic regression models to identify characteristics associated with pulmonary impairment. Among 134 participants with a median CD4 count of 110 cells/μl, 112 (83%) completed baseline spirometry at which time 32 (29%) had restriction, 13 (12%) had obstruction, and 9 (7%) had a mixed pattern. Lung function was dynamic over time and 30 (33%) participants had impaired lung function at 12 months. Baseline restriction was associated with greater symptoms and with long-term pulmonary impairment (adjusted odds ratio 5.44, 95% confidence interval 1.16–25.45), while baseline obstruction was not (adjusted odds ratio 1.95, 95% confidence interval 0.28–13.78). In this cohort of people with HIV and tuberculosis, restriction was the most common, symptomatic, and persistent pattern of pulmonary impairment. These data can help to raise awareness among clinicians about the heterogeneity of post-tuberculosis pulmonary impairment, and highlight the need for further research into mediators of lung injury in this vulnerable population.
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DOI：
10.5588/ijtld.16.0277
发表时间：
2016-08-01
影响因子：
4
作者：
Harries, A. D.;Ade, S.;Castro, J. L.
通讯作者：
Castro, J. L.
DOI：
10.5588/ijtld.18.0313
发表时间：
2019-02-01
影响因子：
4
作者：
Chin, A. T.;Rylance, J.;Metcalfe, J.
通讯作者：
Metcalfe, J.
影响因子：
4.5
作者：
Pasipanodya JG;McNabb SJ;Hilsenrath P;Bae S;Lykens K;Vecino E;Munguia G;Miller TL;Drewyer G;Weis SE
通讯作者：
Weis SE
影响因子：
5.8
作者：
Daniil, Z;Kitsanta, P;Papiris, SA
通讯作者：
Papiris, SA
影响因子：
8
作者：
Ahidjo, Bintou A.;Maiga, Mariama C.;Bishai, William R.
通讯作者：
Bishai, William R.