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Author Notes:

The authors would like to acknowledge the contribution of the study participants and project staff involved with the EXHALE study.


Research Funding:

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.

LH was supported by grant NIH HL 087713.

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.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Immunology
  • Infectious Diseases
  • 6-MWT
  • HIV
  • airflow limitation
  • performance
  • pulmonary function tests
  • FEV1
  • LUNG

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

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Journal Title:

Journal of Acquired Immune Deficiency Syndromes


Volume 65, Number 5


, Pages 557-563

Type of Work:

Article | Post-print: After Peer Review


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.

Copyright information:

© 2013 by Lippincott Williams & Wilkins.

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