Interstitial Lung Abnormalities, Disease More Likely in People With HIV

Individuals with human immunodeficiency virus (HIV) were more likely to have interstitial lung abnormalities and findings suspicious for the presence of interstitial lung disease (ILD) than individuals without HIV, according to study results published in the Journal of Infectious Diseases.

Chest computed tomography (CT) scan results from patients in the Copenhagen Comorbidity in HIV Infection (COCOMO) study were evaluated and the results were compared between groups with and without HIV.

Of the 1224 chest CT scans included in the analysis, 754 were from patients with HIV and 470 were from a control group. When the demographics of the groups were compared, patients with HIV were on average 3 years younger, had a slightly lower body mass index, reported more current and cumulative smoking histories, and reported a higher frequency of respiratory symptoms (eg, chronic cough and dyspnea).

When interstitial lung abnormalities were evaluated, a total of 10.9% of the patients with HIV had any interstitial lung abnormality, 7.8% were classified as equivocal, 2.9% as suspicious, and 0.1% as definite ILD vs 7.7%, 7%, 0.9% and 0%, respectively, in the control group.

Study limitations included the lack of a standardized method for detecting interstitial lung abnormalities, having only one radiologist perform the scoring, and the lack of evaluation of high attenuation areas by densitometry.

Although the researchers were unable to identify HIV-specific related risk factors associated with ILD, they did find a tendency toward increased prevalence of intravenous drug use and a previous history of AIDS, including pneumocystis pneumonia, in individuals with findings suspicious or equivocal for ILD.

The study investigators wrote, “HIV infection was independently associated with presence of interstitial lung abnormalities.” They added, “Future studies should evaluate whether [people with HIV] with interstitial lung abnormalities may progress and experience adverse longitudinal outcomes.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Ronit A, Benfield T, Lundgren J, et al. Interstitial lung abnormalities in people with HIV infection and uninfected controls [published online January 31, 2020]. J Infect Dis. doi:10.1093/infdis/jiaa047