Drummond M Bradley, Lambert Allison A, Hussien Amira F, Lin Cheng T, Merlo Christian A, Wise Robert A, Kirk Gregory D, Brown Robert H
Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, 125 Mason Farm Road, CB# 7248, Chapel Hill, North Carolina 27599.
Department of Medicine, Johns Hopkins University, Baltimore, Maryland.
Acad Radiol. 2017 Feb;24(2):137-145. doi: 10.1016/j.acra.2016.09.019. Epub 2016 Nov 18.
Noninfectious pulmonary complications are common among HIV-infected individuals and may be detected early by quantitative computed tomography (CT) scanning. The association of HIV disease markers with CT lung density measurement remains poorly understood.
One hundred twenty-five participants free of spirometry-defined lung disease were recruited from a longitudinal cohort study of HIV-infected and HIV-uninfected individuals to undergo standardized CT scan of the chest. Parenchymal density for the entire lung volume was calculated using computerized software. Qualitative assessment of CT scans was conducted by two radiologists masked to HIV status. Linear regression models were developed to determine the independent association of markers of HIV infection on inspiratory scan mean lung density (MLD).
HIV-infected participants had a significantly higher MLD (denser lung) compared to HIV-uninfected participants (-815 Hounsfield unit [HU] vs -837 HU; P = 0.002). After adjusting for relevant covariates, HIV infection was independently associated with 19.9 HU higher MLD (95% CI 6.04 to 33.7 HU; P = 0.005). In qualitative assessment, only ground glass attenuation and cysts were noted more commonly among HIV-infected individuals compared to HIV-uninfected individuals (34% vs 17% [P = 0.045] and 27% vs 10% [P = 0.03], respectively). No qualitative radiographic abnormalities attenuated the association between HIV infection and increased MLD.
HIV infection is independently associated with increased lung density. Although qualitative CT abnormalities were common in this cohort, only ground glass attenuation and cysts were noted more frequently in HIV-infected participants, suggesting that the increased lung density observed among HIV-infected individuals may be associated with subclinical inflammatory lung changes.
非感染性肺部并发症在HIV感染者中很常见，可通过定量计算机断层扫描（CT）早期检测出来。HIV疾病标志物与CT肺密度测量之间的关联仍知之甚少。
从一项针对HIV感染者和未感染HIV个体的纵向队列研究中招募了125名无肺量计定义的肺部疾病的参与者，对其进行胸部标准化CT扫描。使用计算机软件计算整个肺容积的实质密度。由两名对HIV感染状况不知情的放射科医生对CT扫描进行定性评估。建立线性回归模型以确定HIV感染标志物与吸气扫描平均肺密度（MLD）之间的独立关联。
与未感染HIV的参与者相比，感染HIV的参与者的MLD显著更高（肺更致密）（-815亨氏单位[HU]对-837 HU；P = 0.002）。在调整相关协变量后，HIV感染与MLD升高19.9 HU独立相关（95%CI 6.04至33.7 HU；P = 0.005）。在定性评估中，与未感染HIV的个体相比，仅磨玻璃影和囊肿在感染HIV的个体中更常见（分别为34%对17%[P = 0.045]和27%对10%[P = 0.03]）。没有定性的影像学异常减弱HIV感染与MLD增加之间的关联。
HIV感染与肺密度增加独立相关。尽管该队列中定性CT异常很常见，但仅磨玻璃影和囊肿在感染HIV的参与者中更频繁出现，这表明在感染HIV的个体中观察到的肺密度增加可能与亚临床炎症性肺部改变有关。
