Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America.
Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, Washington, United States of America.
PLoS One. 2019 Apr 24;14(4):e0212975. doi: 10.1371/journal.pone.0212975. eCollection 2019.
Ambulatory function predicts morbidity and mortality and may be influenced by cardiopulmonary dysfunction. Persons living with HIV (PLWH) suffer from a high prevalence of cardiac and pulmonary comorbidities that may contribute to higher risk of ambulatory dysfunction as measured by 6-minute walk test distance (6-MWD). We investigated the effect of HIV on 6-MWD.
PLWH and HIV-uninfected individuals were enrolled from 2 clinical centers and completed a 6-MWD, spirometry, diffusing capacity for carbon monoxide (DLCO) and St. George's Respiratory Questionnaire (SGRQ). Results of 6-MWD were compared between PLWH and uninfected individuals after adjusting for confounders. Multivariable linear regression analysis was used to determine predictors of 6-MWD.
Mean 6-MWD in PLWH was 431 meters versus 462 in 130 HIV-uninfected individuals (p = 0.0001). Older age, lower forced expiratory volume (FEV1)% or lower forced vital capacity (FVC)%, and smoking were significant predictors of decreased 6-MWD in PLWH, but not HIV-uninfected individuals. Lower DLCO% and higher SGRQ were associated with lower 6-MWD in both groups. In a combined model, HIV status remained an independent predictor of decreased 6-MWD (Mean difference = -19.9 meters, p = 0.005).
HIV infection was associated with decreased ambulatory function. Airflow limitation and impaired diffusion capacity can partially explain this effect. Subjective assessments of respiratory symptoms may identify individuals at risk for impaired physical function who may benefit from early intervention.
门诊功能可预测发病率和死亡率，可能受心肺功能障碍的影响。 艾滋病毒感染者（PLWH）患有高比例的心脏和肺部合并症，这可能导致 6 分钟步行试验距离（6-MWD）测量的活动障碍风险更高。 我们研究了 HIV 对 6-MWD 的影响。
从 2 个临床中心招募 PLWH 和未感染 HIV 的个体，并完成 6-MWD、肺量测定、一氧化碳弥散量（DLCO）和圣乔治呼吸问卷（SGRQ）。 在调整混杂因素后，比较 PLWH 和未感染个体的 6-MWD 结果。 多变量线性回归分析用于确定 6-MWD 的预测因素。
PLWH 的平均 6-MWD 为 431 米，而 130 名未感染 HIV 的个体为 462 米（p = 0.0001）。 年龄较大、较低的用力呼气量（FEV1）%或较低的用力肺活量（FVC）%，以及吸烟是 PLWH 6-MWD 下降的显著预测因素，但不是未感染 HIV 的个体。 较低的 DLCO%和较高的 SGRQ 与两组个体的较低 6-MWD 相关。 在综合模型中，HIV 状态仍然是 6-MWD 降低的独立预测因素（平均差异=-19.9 米，p = 0.005）。
HIV 感染与活动能力下降相关。 气流受限和弥散能力受损可能部分解释这种影响。 呼吸症状的主观评估可能会识别出有活动障碍风险的个体，这些个体可能受益于早期干预。
