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Time-related decrease in diffusion capacity in HIV-infected patients with impaired immune function.

V Backer1, B Nybo Jensen, C Pedersen

  • 1Department of Medicine B, Rigshospitalet, Copenhagen, Denmark.

Scandinavian Journal of Infectious Diseases
|January 1, 1992
PubMed
Summary
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HIV patients with low CD4 counts show decreased lung function over time. Even without symptoms, the transfer factor (KCO) declines, indicating early lung impairment in HIV. Pneumonia causes acute drops in KCO, FEV1, and VC.

Area of Science:

  • Pulmonary Medicine
  • Infectious Diseases
  • Immunology

Background:

  • HIV infection can compromise immune function, increasing susceptibility to pulmonary complications.
  • Lung function abnormalities are common in HIV-infected individuals, even in the absence of overt symptoms.

Purpose of the Study:

  • To examine acute and time-related changes in lung function parameters (FEV1, VC, KCO) in HIV-infected males with CD4 counts < 400 cells/µL.
  • To identify early indicators of pulmonary compromise in asymptomatic HIV patients.

Main Methods:

  • Prospective study of 66 HIV-infected males over 9 months with 3-month lung function assessments.
  • Pulmonary function tests including forced expiratory volume in 1 second (FEV1), vital capacity (VC), and transfer factor (KCO).
  • Monitoring for development of acute pulmonary symptoms.

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Main Results:

  • 23% of patients developed acute pulmonary symptoms (dyspnea, cough, fever, infiltrates).
  • Asymptomatic patients showed a significant time-related decrease in KCO (7% median decrease).
  • Patients who developed pneumonia experienced significant acute decreases in KCO (17% median decrease), FEV1, and VC.

Conclusions:

  • HIV-infected patients with low CD4 counts exhibit declining KCO even without pulmonary symptoms, suggesting subclinical lung impairment.
  • Pneumonia in this cohort leads to acute, significant reductions in KCO, FEV1, and VC.