CROI 2017 Abstract e-Book

Abstract eBook

Poster and Themed Discussion Abstracts

Poster and Themed Discussion Abstracts

655 CHRONIC HIV PULMONARY DISEASE (CHPD) IN NEVER-SMOKING HIV PATIENTS Antonella Santoro 1 , Riccardo Scaglioni 1 , Giulia Besutti 1 , Andrea Malagoli 1 , Jonathon Leipsic 2 , Janice Leung 2 , Gabriella Orlando 1 , Stefano Zona 1 , Guido Ligabue 1 , Giovanni Guaraldi 1 1 Univ of Modena and Reggio Emilia, Modena, Italy, 2 Univ of British Columbia, Vancouver, British Columbia, Canada Background: The aim of this study was to characterize lung diseases by mean of: CT lung abnormalities, lung function and respiratory symptoms in never smoking HIV patients (pts) on antiretroviral therapy, not referred for acute pulmonary disease Methods: Cross-sectional study of 329 HIV patients, never smoking (currently non-smoking and with a pack-year <1) who underwent chest and abdominal CT scans for the evaluation of Coronary Artery Calcium score (CACs) and for the assessment of subcutaneous and visceral adipose tissue (SAT and VAT). Epicardial adipose tissue (EAT) was calculated in a subset of 153 patients. CT Images were evaluated for pulmonary findings by 3 radiologists by consensus. Emphysema was classified by severity score (mild, moderate, severe) and by subtype (centrilobular, paraseptal, panlobular). Prevalence of respiratory symptoms was assessed with St. George Respiratory Questionnarie (SGRQ). Impairment was defined with Symptoms Score>15. COPD was defined by spirometry (forced expiratory volume in one second/forced vital capacity < 0.70); DLCO was considered reduced if <70% of predicted value. Univariable and multivariable logistic regression analyses were performed to identify factors independently associated with the presence of lung disease. Results: Emphysema was found in 15.57% of pts (centrilobular 43%, Paraseptal 30%, panlobular 17%. Mild was 62%, Moderate 13%, Severe 25%). Bronchiolitis was found in 11.7% of pts, Bronchial Wall Thickening in 38.8%, Bronchiectasis in 14.8% and nodules >4mm in10%. Patients complained following respiratory symptoms: cough (22.4%) spit (14 %), loss of breath (16.8%) and whistles (8.4%). COPD was diagnosed in 1,2% of pts, DLCO reduction in 15%of pts. Table 1 shows demographic and clinical characteristics of patients with and without emphysema. Univariable analysis showed significant associations between the presence of emphysema and: age (p=0,001), Framingham risk score (p=0,01), Hypertension (p=0,012), CACs (p=0,012), diabetes (p=0,048), VAT (p=0,006) and EAT (p=0,004). In a multivariable model, significant predictors of emphysema severity were: age (OR=1.098) and EAT (OR=1.015). Conclusion: We described a Chronic HIV Pulmonary Disease (CHPD) in never smoking HIV patients with emphysematous lung changes, respiratory symptoms and reduced CO diffusion capacity. Emphysema was independently associated with EAT, but not BMI or HIV-related variables underlying a common pathogenetic mechanism linking lung CT abnormalities and ectopic fat accumulation.

CROI 2017 281