Pulmonary arterial enlargement is common in persons living with HIV (PWH), according to recent results published in the Journal of Infectious Diseases.
People with HIV (n=900), and age and sex-matched uninfected controls (n=752), over 40 years of age, were recruited from the ongoing Copenhagen Comorbidity in HIV infection (COCOMO) study and the Copenhagen General Population Study, respectively. PWH were predominantly well (n=887) and currently using combined antiretroviral therapy (cART), and 847 had undetectable viral replication.
Pulmonary artery enlargement was defined, by chest computed tomography, as the ratio of the diameter of the pulmonary artery at its bifurcation, by the diameter of the ascending aorta (PA:A)>1. The mean age was 51 (SD 11 years), and 119 (13%) were female. The prevalence of PA:A>1 was 44 (5%) in PWH and 13 (1.7%) in controls.
In unadjusted analysis, PA:A>1 was associated with lower age (OR: 0.34 [0.24, 0.47] per decade older, P
PA:A>1 was not associated with female sex, current or former smoking, airflow limitation by spirometry and/or CT-emphysema, or the use of recreational drugs (except IDU).
In adjusted regressions, lower age (aOR: 0.29 [0.20, 0.43] per decade older, P1.
HIV seropositivity was borderline associated with PA:A>1.
In sensitivity analysis using PA:A>1.08, obesity and HCV was not associated with pulmonary artery enlargement. This may indicate that associations between HCV and PA:A represent confounding by IDU, or factors related to IDU.
Increased awareness of pulmonary arterial enlargement may be appropriate in obese PWH.