Details

Autor(en) / Beteiligte

• Oomen, Patrick G A
• Bronsveld, Inez
• Hoepelman, Andy I M
• van Welzen, Berend J
• Mudrikova, Tania

Titel

No long-term effect of past Pneumocystis jirovecii pneumonia on pulmonary function in people with HIV

Ist Teil von

• AIDS (London), 2023-07, Vol.37 (8), p.1263-1267

Ort / Verlag

England: Lippincott Williams & Wilkins

Erscheinungsjahr

2023

Link zum Volltext

Quelle

EZB Free E-Journals

Beschreibungen/Notizen

• To assess the impact of past Pneumocystis jirovecii pneumonia (PJP) on the pulmonary diffusion capacity in people with HIV (PWH) with a history of advanced immunodeficiency. Prospective cross-sectional study. Adult PWH with past PJP >1 year ago were included as the study group. The control group consisted of PWH with a nadir CD4+ lymphocyte count <200 cells/mm3, matched by age, sex, smoking status and time since HIV diagnosis. All PWH completed a pulmonary function test (PFT) consisting of pre-bronchodilation spirometry, body plethysmography and single-breath carbon monoxide transfer factor (TLCO) measurement. TLCO, diffusion impairment (defined as a TLCO Z-score <-1.645), total lung capacity (TLC) and forced expiratory volume in one second/forced vital capacity (FEV1/FVC) Z-scores were assessed. Multivariable regression analyses were conducted with Z-scores and odds of diffusion impairment as outcomes. PFTs of 102 participants were analyzed, 51 of whom had past PJP with a median of ten years since PJP. Mean TLCO Z-score and diffusion impairment rate did not differ significantly between groups (P = 0.790; P = 0.650). Past PJP was not independently associated with TLCO Z-score [β = 0.14; 95% confidence interval (CI) -0.30-0.57], diffusion impairment (odds ratio 1.00; 95% CI 0.36-2.75) nor TLC or FEV1/FVC Z-scores, whereas current (vs. never) smoking was associated with more diffusion impairment and lower TLCO Z-scores. In our study, past PJP was not associated with long-term diffusion impairment. Our findings suggest that smoking plays a more important role in persistent pulmonary function impairment whereas PJP-related changes seem to be reversible.