Abnormal Airway Function in Individuals with the Acquired Immunodeficiency Syndrome: Results
Prevalence of Abnormal Airway Function in AIDS
From January 1983 to July 1986, 105 AIDS patients were referred for pulmonary physiologic assessment. Ninety-nine (94.3 percent) of these individuals were able to perform three FVC maneuvers acceptable for analysis. The 105 patients referred to the PFT lab represent 68.6 percent of those with AIDS who were treated as either inpatients or outpatients at the New England Deaconess Hospital. The mean age of this group was 34.6 (± 8.2 SD) years. Seventy-two percent of these individuals were tested on an outpatient basis. Ninety-six percent were male and 92 percent were homosexual. review
In this sample, decreased airflow rate was observed in 33 (33 percent) cases, while a significant response to bronchodilators was detected in 31 (31 percent) cases. The distribution of pulmonary function test results is shown in Figure 1. Overall, among those with AIDS, 44 (42 percent) individuals had abnormal airway function. Eleven individuals had a significant bronchodilator response in the presence of normal baseline flow rates. In six instances, obstruction was present in association with an FVC of less than 80 percent of predicted. Twenty-five individuals had an abnormally low FEVj/FVC ratio, while an additional eight subjects had low FEF 25-75% values with a normal 1 s ratio. Among those with a significant bronchodilator response, 16 had improvement in the FEVi, and an additional 11 had improved FEF 2575% values alone.
Comparison of individuals with and without abnormal test results revealed no differences with respect to mean age or duration of AIDS. Cigarette smoking, defined as a minimum of five pack-years total exposure, was not more common among individuals with airflow obstruction. Fourteen of 35 smokers (40 percent), as compared with 30 or 64 nonsmokers (47 percent), had abnormal airway function. Of six individuals with a history of asthma, four had a significant response to bronchodilator.
Figure 1. Distribution of pulmonary (unction test results among AIDS patients.