Dyspnea and Pulmonary Function Among Participants in the Multicenter AIDS Cohort Study Using Protease Inhibitors: A...

Area of Science:

• Pulmonology
• Infectious Diseases
• Clinical Medicine

Background:

• People living with HIV (PLWH) exhibit a higher incidence of respiratory symptoms compared to HIV-negative individuals.
• Antiretroviral therapy, particularly protease inhibitor (PI) use, has been linked to diminished airflow limitation in PLWH.

Purpose of the Study:

• To investigate the association between protease inhibitor (PI) use and respiratory health impairment in people living with HIV (PLWH).
• To compare respiratory health outcomes among PI users, non-PI users, and HIV-negative individuals.

Main Methods:

• Cross-sectional study utilizing data from the Multicenter AIDS Cohort Study (MACS) between April 2017 and March 2018.
• Participants completed the St. George's Respiratory Questionnaire (SGRQ), modified Medical Research Council (mMRC) dyspnea scale, spirometry, and diffusion capacity tests.
• Binary and ordinal logistic regression models analyzed associations between HIV status, PI use, and respiratory outcomes (SGRQ and mMRC scores).

Main Results:

• A higher prevalence of self-reported pulmonary disease was observed in PI users (32.2%) compared to non-PI users (26.4%) and HIV-negative men (19.2%).
• Significantly more PI users (45.3%) reported SGRQ scores ≥10, indicating poorer respiratory health, than non-PI users (34.7%) and HIV-negative individuals (29.9%).
• Adjusted analyses revealed that PI use was significantly associated with higher SGRQ scores (OR 1.91) and mMRC scores (OR 1.79) compared to HIV-negative individuals.

Conclusions:

• Protease inhibitor (PI) use in people living with HIV (PLWH) is independently associated with worse respiratory health status.
• PI use correlates with increased dyspnea and a higher prevalence of self-reported pulmonary disease.
• Findings underscore the need for monitoring respiratory health in PLWH on PI-based antiretroviral therapy.