Department of Community Medicine, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway.
Clinical Research Department, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK.
AIDS. 2019 Sep 1;33(11):1711-1718. doi: 10.1097/QAD.0000000000002265.
HIV disrupts host defense mechanisms and maintains chronic inflammation in the lung. Nitric oxide is a marker of lung inflammation and can be measured in the exhaled air. We investigated the relationship between exhaled nitric oxide (eNO), HIV status and airway abnormalities in perinatally HIV-infected children aged 6-19 years.
A cross-sectional study.
HIV-infected individuals on antiretroviral therapy and HIV-uninfected children with no active tuberculosis (TB) or acute respiratory tract infection were recruited from a public hospital in Harare, Zimbabwe. Clinical history was collected and eNO testing and spirometry was performed. The association between eNO and explanatory variables (HIV, FEV1 z-score, CD4 cell count, viral load, history of TB) was investigated using linear regression analysis adjusted for age, sex and time of eNO testing.
In total, 222 HIV-infected and 97 HIV-uninfected participants were included. Among HIV-infected participants, 57 (25.7%) had a history of past TB; 56 (25.2%) had airway obstruction, but no prior TB. HIV status was associated with lower eNO level [mean ratio 0.79 (95% confidence interval, 95% CI 0.65-0.97), P = 0.03]. Within the HIV-infected group, history of past TB was associated with lower eNO levels after controlling for age, sex and time of eNO testing [0.79 (95% CI 0.67-0.94), P = 0.007].
HIV infection and history of TB were associated with lower eNO levels. eNO levels may be a marker of HIV and TB-induced alteration in pulmonary physiology; further studies focused on potential causes for lower eNO levels in HIV and TB are warranted.
HIV 会破坏宿主防御机制并使肺部持续处于慢性炎症状态。一氧化氮（NO）是肺部炎症的标志物，可以通过呼出气进行测量。我们研究了呼出气一氧化氮（eNO）、HIV 状态与经胎盘感染 HIV 的 6-19 岁儿童的气道异常之间的关系。
一项横断面研究。
我们从津巴布韦哈拉雷的一家公立医院招募了正在接受抗逆转录病毒治疗的 HIV 感染者和没有活动性肺结核（TB）或急性呼吸道感染的 HIV 未感染者。收集临床病史，并进行 eNO 检测和肺量测定。使用线性回归分析调整年龄、性别和 eNO 检测时间后，研究 eNO 与解释变量（HIV、FEV1 z 评分、CD4 细胞计数、病毒载量、TB 病史）之间的关系。
共纳入 222 名 HIV 感染者和 97 名 HIV 未感染者。在 HIV 感染者中，57 名（25.7%）有既往 TB 病史；56 名（25.2%）有气道阻塞，但无既往 TB 病史。HIV 状态与较低的 eNO 水平相关[平均比值 0.79（95%置信区间，95%CI 0.65-0.97），P=0.03]。在校正年龄、性别和 eNO 检测时间后，HIV 感染者中既往 TB 病史与较低的 eNO 水平相关[0.79（95%CI 0.67-0.94），P=0.007]。
HIV 感染和 TB 病史与较低的 eNO 水平相关。eNO 水平可能是 HIV 和 TB 引起的肺生理学改变的标志物；需要进一步研究以确定 HIV 和 TB 导致 eNO 水平降低的潜在原因。
