Isolated abnormal diffusing capacity for carbon monoxide (iso↓DLco) is associated with increased respiratory symptom burden in people with HIV infection.
<h4>Objectives</h4>An isolated reduction in the diffusing capacity for carbon monoxide (DLco; iso↓DLco) is one of the most common pulmonary function test (PFT) abnormalities in people living with HIV (PWH), but its clinical implications are incompletely understood. In this study, we expl...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2023-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0288803&type=printable |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849717915145732096 |
|---|---|
| author | Katerina L Byanova Jessica Fitzpatrick Amanda K Jan Maggie McGing Marlena Hartman-Filson Carly K Farr Michelle Zhang Kendall Gardner Jake Branchini Robert Kerruish Sharvari Bhide Aryana Bates Jenny Hsieh Rebecca Abelman Peter W Hunt Richard J Wang Kristina A Crothers Laurence Huang |
| author_facet | Katerina L Byanova Jessica Fitzpatrick Amanda K Jan Maggie McGing Marlena Hartman-Filson Carly K Farr Michelle Zhang Kendall Gardner Jake Branchini Robert Kerruish Sharvari Bhide Aryana Bates Jenny Hsieh Rebecca Abelman Peter W Hunt Richard J Wang Kristina A Crothers Laurence Huang |
| author_sort | Katerina L Byanova |
| collection | DOAJ |
| description | <h4>Objectives</h4>An isolated reduction in the diffusing capacity for carbon monoxide (DLco; iso↓DLco) is one of the most common pulmonary function test (PFT) abnormalities in people living with HIV (PWH), but its clinical implications are incompletely understood. In this study, we explored whether iso↓DLco in PWH is associated with a greater respiratory symptom burden.<h4>Study design</h4>Cross-sectional analysis.<h4>Methods</h4>We used ATS/ERS compliant PFTs from PWH with normal spirometry (post-bronchodilator FEV1/FVC ≥0.7; FEV1, FVC ≥80% predicted) from the I AM OLD cohort in San Francisco, CA and Seattle, WA, grouped by DLco categorized as normal (DLco ≥lower limit of normal, LLN), mild iso↓DLco (LLN >DLco >60% predicted), and moderate-severe iso↓DLco (DLco ≤60% predicted). We performed multivariable analyses to test for associations between DLco and validated symptom-severity and quality of life questionnaires, including the modified Medical Research Council dyspnea scale (mMRC), the COPD Assessment Test (CAT), and St. George's Respiratory Questionnaire (SGRQ), as well as between DLco and individual CAT symptoms.<h4>Results</h4>Mild iso↓DLco was associated only with a significantly higher SGRQ score. Moderate-severe iso↓DLco was associated with significantly higher odds of mMRC ≥2 and significantly higher CAT and SGRQ scores. PWH with moderate-severe iso↓DLco had increased odds of breathlessness, decreased activity, lower confidence leaving home, and less energy.<h4>Conclusions</h4>Iso↓DLco is associated with worse respiratory symptom scores, and this association becomes stronger with worsening DLco, suggesting that impaired gas exchange alone has a significant negative impact on the quality of life in PWH. Additional studies are ongoing to understand the etiology of this finding and design appropriate interventions. |
| format | Article |
| id | doaj-art-44cab78bc50a4c3d89755fb8929c67a5 |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-44cab78bc50a4c3d89755fb8929c67a52025-08-20T03:12:31ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01187e028880310.1371/journal.pone.0288803Isolated abnormal diffusing capacity for carbon monoxide (iso↓DLco) is associated with increased respiratory symptom burden in people with HIV infection.Katerina L ByanovaJessica FitzpatrickAmanda K JanMaggie McGingMarlena Hartman-FilsonCarly K FarrMichelle ZhangKendall GardnerJake BranchiniRobert KerruishSharvari BhideAryana BatesJenny HsiehRebecca AbelmanPeter W HuntRichard J WangKristina A CrothersLaurence Huang<h4>Objectives</h4>An isolated reduction in the diffusing capacity for carbon monoxide (DLco; iso↓DLco) is one of the most common pulmonary function test (PFT) abnormalities in people living with HIV (PWH), but its clinical implications are incompletely understood. In this study, we explored whether iso↓DLco in PWH is associated with a greater respiratory symptom burden.<h4>Study design</h4>Cross-sectional analysis.<h4>Methods</h4>We used ATS/ERS compliant PFTs from PWH with normal spirometry (post-bronchodilator FEV1/FVC ≥0.7; FEV1, FVC ≥80% predicted) from the I AM OLD cohort in San Francisco, CA and Seattle, WA, grouped by DLco categorized as normal (DLco ≥lower limit of normal, LLN), mild iso↓DLco (LLN >DLco >60% predicted), and moderate-severe iso↓DLco (DLco ≤60% predicted). We performed multivariable analyses to test for associations between DLco and validated symptom-severity and quality of life questionnaires, including the modified Medical Research Council dyspnea scale (mMRC), the COPD Assessment Test (CAT), and St. George's Respiratory Questionnaire (SGRQ), as well as between DLco and individual CAT symptoms.<h4>Results</h4>Mild iso↓DLco was associated only with a significantly higher SGRQ score. Moderate-severe iso↓DLco was associated with significantly higher odds of mMRC ≥2 and significantly higher CAT and SGRQ scores. PWH with moderate-severe iso↓DLco had increased odds of breathlessness, decreased activity, lower confidence leaving home, and less energy.<h4>Conclusions</h4>Iso↓DLco is associated with worse respiratory symptom scores, and this association becomes stronger with worsening DLco, suggesting that impaired gas exchange alone has a significant negative impact on the quality of life in PWH. Additional studies are ongoing to understand the etiology of this finding and design appropriate interventions.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0288803&type=printable |
| spellingShingle | Katerina L Byanova Jessica Fitzpatrick Amanda K Jan Maggie McGing Marlena Hartman-Filson Carly K Farr Michelle Zhang Kendall Gardner Jake Branchini Robert Kerruish Sharvari Bhide Aryana Bates Jenny Hsieh Rebecca Abelman Peter W Hunt Richard J Wang Kristina A Crothers Laurence Huang Isolated abnormal diffusing capacity for carbon monoxide (iso↓DLco) is associated with increased respiratory symptom burden in people with HIV infection. PLoS ONE |
| title | Isolated abnormal diffusing capacity for carbon monoxide (iso↓DLco) is associated with increased respiratory symptom burden in people with HIV infection. |
| title_full | Isolated abnormal diffusing capacity for carbon monoxide (iso↓DLco) is associated with increased respiratory symptom burden in people with HIV infection. |
| title_fullStr | Isolated abnormal diffusing capacity for carbon monoxide (iso↓DLco) is associated with increased respiratory symptom burden in people with HIV infection. |
| title_full_unstemmed | Isolated abnormal diffusing capacity for carbon monoxide (iso↓DLco) is associated with increased respiratory symptom burden in people with HIV infection. |
| title_short | Isolated abnormal diffusing capacity for carbon monoxide (iso↓DLco) is associated with increased respiratory symptom burden in people with HIV infection. |
| title_sort | isolated abnormal diffusing capacity for carbon monoxide iso↓dlco is associated with increased respiratory symptom burden in people with hiv infection |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0288803&type=printable |
| work_keys_str_mv | AT katerinalbyanova isolatedabnormaldiffusingcapacityforcarbonmonoxideisodlcoisassociatedwithincreasedrespiratorysymptomburdeninpeoplewithhivinfection AT jessicafitzpatrick isolatedabnormaldiffusingcapacityforcarbonmonoxideisodlcoisassociatedwithincreasedrespiratorysymptomburdeninpeoplewithhivinfection AT amandakjan isolatedabnormaldiffusingcapacityforcarbonmonoxideisodlcoisassociatedwithincreasedrespiratorysymptomburdeninpeoplewithhivinfection AT maggiemcging isolatedabnormaldiffusingcapacityforcarbonmonoxideisodlcoisassociatedwithincreasedrespiratorysymptomburdeninpeoplewithhivinfection AT marlenahartmanfilson isolatedabnormaldiffusingcapacityforcarbonmonoxideisodlcoisassociatedwithincreasedrespiratorysymptomburdeninpeoplewithhivinfection AT carlykfarr isolatedabnormaldiffusingcapacityforcarbonmonoxideisodlcoisassociatedwithincreasedrespiratorysymptomburdeninpeoplewithhivinfection AT michellezhang isolatedabnormaldiffusingcapacityforcarbonmonoxideisodlcoisassociatedwithincreasedrespiratorysymptomburdeninpeoplewithhivinfection AT kendallgardner isolatedabnormaldiffusingcapacityforcarbonmonoxideisodlcoisassociatedwithincreasedrespiratorysymptomburdeninpeoplewithhivinfection AT jakebranchini isolatedabnormaldiffusingcapacityforcarbonmonoxideisodlcoisassociatedwithincreasedrespiratorysymptomburdeninpeoplewithhivinfection AT robertkerruish isolatedabnormaldiffusingcapacityforcarbonmonoxideisodlcoisassociatedwithincreasedrespiratorysymptomburdeninpeoplewithhivinfection AT sharvaribhide isolatedabnormaldiffusingcapacityforcarbonmonoxideisodlcoisassociatedwithincreasedrespiratorysymptomburdeninpeoplewithhivinfection AT aryanabates isolatedabnormaldiffusingcapacityforcarbonmonoxideisodlcoisassociatedwithincreasedrespiratorysymptomburdeninpeoplewithhivinfection AT jennyhsieh isolatedabnormaldiffusingcapacityforcarbonmonoxideisodlcoisassociatedwithincreasedrespiratorysymptomburdeninpeoplewithhivinfection AT rebeccaabelman isolatedabnormaldiffusingcapacityforcarbonmonoxideisodlcoisassociatedwithincreasedrespiratorysymptomburdeninpeoplewithhivinfection AT peterwhunt isolatedabnormaldiffusingcapacityforcarbonmonoxideisodlcoisassociatedwithincreasedrespiratorysymptomburdeninpeoplewithhivinfection AT richardjwang isolatedabnormaldiffusingcapacityforcarbonmonoxideisodlcoisassociatedwithincreasedrespiratorysymptomburdeninpeoplewithhivinfection AT kristinaacrothers isolatedabnormaldiffusingcapacityforcarbonmonoxideisodlcoisassociatedwithincreasedrespiratorysymptomburdeninpeoplewithhivinfection AT laurencehuang isolatedabnormaldiffusingcapacityforcarbonmonoxideisodlcoisassociatedwithincreasedrespiratorysymptomburdeninpeoplewithhivinfection |