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Inflammatory biomarkers in the pathogenesis of respiratory dysfunction in people living with HIV

Author(s):

Isabel Ribes*, Sergio Reus, Santos Asensio, Mar García-Ródenas, Rafael León, Irene Portilla-Tamarit, Livia Giner and Joaquín Portilla  

Abstract:


Background: Although the association between HIV infection and airway obstruction is well known, its etiopathogenesis is not clear.

Objectives: Our aim was to analyze the association between biomarkers of systemic inflammation and bacterial translocation and pulmonary function tests in HIV-infected patients and compare the results between smokers and non-smokers.

Method: It was a cross-sectional, observational study. The inclusion criterion of the study was people living with HIV with undetectable plasma viral load. The exclusion criterion was other comorbidities associated with systemic inflammation. Outcome variables were spirometry and diffusing capacity for carbon monoxide; explanatory variables were inflammatory biomarkers (interleukin-6, tumor necrosis factor-alpha), bacterial translocation (soluble CD14 [sCD14] and bacterial 16S rDNA), and variables related to HIV infection. Associations were tested using the Pearson/Spearman correlation tests, the Student t-test, and multivariable linear regression.

Results: We included 71 patients (54.9% smokers). We did not observe significant differences in pulmonary function tests according to biomarkers of inflammation or bacterial translocation. In non-smokers (n=32), sCD14 was negatively correlated with forced expiratory volume in 1 second (R = −0.35, P = 0.048) and forced vital capacity (R= −0.40, P=0.023). Age, time since HIV diagnosis, and CD4+ nadir were associated with alterations in PFTs. In smokers, the only association observed was between the pack-years and pulmonary obstruction.

Conclusion: In non-smokers, HIV patients' lung dysfunction can be, at least partially, related to bacterial translocation (sCD14), CD4+ nadir, and time since HIV diagnosis.

Keywords:

HIV, bacterial translocation, inflammation, spirometry, chronic obstructive pulmonary disease, smoking

Affiliation:

Infectious Diseases Unit, General University Hospital of Alicante, Alicante, Infectious Diseases Unit, General University Hospital of Alicante, Alicante, Pneumonology Department, General University Hospital of Alicante, Alicante, Pneumonology Department, General University Hospital of Alicante, Alicante, Infectious Diseases Unit, General University Hospital of Alicante, Alicante, Infectious Diseases Unit, General University Hospital of Alicante, Alicante, Infectious Diseases Unit, General University Hospital of Alicante, Alicante, Infectious Diseases Unit, General University Hospital of Alicante, Alicante



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