Association of Chronic Cough and Pulmonary Function With 6-Minute Walk Test Performance in HIV Infection

• Type of Material: Article
• Authors: Monica Campo, University of Washington; Kisann K. Oursler, Baltimore Veterans Affairs Medical Center; Laurence Huang, University of California, San Francisco; Matthew Goetz, Veterans Affairs Greater Los Angeles Healthcare System; David Rimland, Emory University; Guy Soo Hoo, Veterans Affairs Greater Los Angeles Healthcare System; Sheldon Brown, James J. Peters Veterans Affairs Medical Center; Maria Rodriguez-Barradas, Michael E. DeBakey VA Medical Center; David Au, University of Washington; Kathleen M. Akguen, Veterans Affairs Greater Los Angeles Healthcare System; Shahida Shahrir, University of Washington; Kristina Crothers, University of Washington
• Language: English
• Date: 2014-04-15
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2013 by Lippincott Williams & Wilkins.
• Final Published Version (URL): http://dx.doi.org/10.1097/QAI.0000000000000086
• Title of Journal or Parent Work: Journal of Acquired Immune Deficiency Syndromes
• ISSN: 1525-4135
• Volume: 65
• Issue: 5
• Start Page: 557
• End Page: 563
• Grant/Funding Information: LH was supported by grant NIH HL 087713.; This study was funded in part by a grant from the National Institutes of Health (NIH) HL090342 (to KC); MC was supported by the Firland Foundation.; KAO supported by grant NIH R01 HL095136 and K23 AG02489.; Dr Au was supported through the Department of Veterans Affairs (VA), Health Services Research and Development.; KMA was supported by the Association of Subspecialty Physicians and CHEST Foundation of the American College of Chest Physicians T. Franklin Williams Award and VA V1CDA2012-20.
• Keywords: LUNG; HIV; Immunology; HUMAN-IMMUNODEFICIENCY-VIRUS; Infectious Diseases; airflow limitation; Life Sciences & Biomedicine; DISTANCE; PEAK OXYGEN-UPTAKE; ADULTS; REFERENCE EQUATIONS; RESPIRATORY SYMPTOMS; FEV1; DIFFUSING-CAPACITY; VETERANS AGING COHORT; performance; pulmonary function tests; 6-MWT; ANTIRETROVIRAL THERAPY; Science & Technology
• Research Categories: Health Sciences, Medicine and Surgery; Biology, Virology

Abstract

Objective: Chronic lung disease has been associated with greater impairment in self-reported physical function in HIV-infected patients. We sought to study this association using objective measures of physical function and pulmonary function. Design: Baseline data from the Examinations of HIV Associated Lung Emphysema study, a multicenter observational cohort of HIVinfected and uninfected veterans. Methods: We assessed the association between clinical, laboratory, and pulmonary function measures with 6-minute walk test (6-MWT). Multivariable linear regression models were generated to identify factors associated with 6-MWT performance. Results: Three hundred forty participants completed 6-MWT (mean age 55 years), with 68% blacks, 94% men, and 62% current smokers. Overall, 180 (53%) were HIV-infected and 63 (19%) had spirometry-defined chronic obstructive pulmonary disease. In a multivariable model, age, current smoking, and obesity (body mass index < 30) were independently associated with lower 6-MWT performance, but HIV infection was not; there was a significant interaction between HIV and chronic cough, such that distance walked among HIV-infected participants with chronic cough was 51.76 m less (P = 0.04) compared with those without cough or HIV. Among HIV-infected participants, the forced expiratory volume in 1 second (FEV1, percent predicted), to a greater extent than total lung capacity or diffusing capacity, attenuated the association with chronic cough; decreased FEV1 was independently associated with lower 6-MWT performance in those with HIV. Conclusions: Older age, current smoking, and airflow limitation were important determinants of 6-MWT performance in the HIVinfected participants. These findings suggest that potential interventions to improve physical function may include early management of respiratory symptoms and airflow limitation.