Pulmonary Arterial Enlargement in Well-Treated Persons With Human Immunodeficiency Virus.
BACKGROUND
Pulmonary artery enlargement is a marker of pulmonary hypertension. We aimed to determine the proportion with pulmonary artery enlargement among well-treated persons with human immunodeficiency virus HIV (PWH) and uninfected controls.


METHODS
PWH with a chest computed tomography were included from the ongoing Copenhagen Comorbidity in HIV Infection (COCOMO) study. Age and sex-matched uninfected controls were recruited from the Copenhagen General Population Study. Pulmonary artery enlargement was defined as a ratio of >1 between the diameter of the main pulmonary artery (at the level of its bifurcation) and the diameter of the ascending aorta.


RESULTS
In total, 900 PWH were included, and 44 (5%) had a pulmonary artery-aorta ratio (PA:A) >1. After adjustment for age, sex, and body mass index, obesity (adjusted odds ratio, 4.33; 95% confidence interval, 1.76-10.65; P = .001) and injection drug use (IDU) (4.90; 1.00-18.46; P = .03) were associated with higher odds of having a PA:A >1, and pulmonary indices and smoking status were not. HIV seropositivity was borderline associated with a PA:A >1 (adjusted odds ratio, 1.89; 95% confidence interval, .92-3.85; P = .08).


CONCLUSIONS
A PA:A >1 was common in PWH. Obesity and IDU were independently associated with this finding and HIV serostatus was borderline associated with it, but HIV-related factors were not. Increased awareness may be appropriate in obese PWH and those with IDU.
['Knudsen|Andreas D|AD|', 'Ronit|Andreas|A|', 'Kristensen|Thomas|T|', 'Thomsen|Magda Teresa|MT|', 'Lebech|Anne-Mette|AM|', 'Cuong|Michael Huy|MH|', 'Sigvardsen|Per Ejlstrup|PE|', 'Kühl|Jørgen Tobias|JT|', 'Fuchs|Andreas|A|', 'Køber|Lars|L|', 'Lundgren|Jens|J|', 'Vestbo|Jørgen|J|', 'Kofoed|Klaus F|KF|', 'Nielsen|Susanne D|SD|']
D000328:Adult D001011:Aorta D016022:Case-Control Studies D005260:Female D015658:HIV Infections D006801:Humans D006976:Hypertension, Pulmonary D008137:Longitudinal Studies D008297:Male D008875:Middle Aged D009765:Obesity D011651:Pulmonary Artery D012307:Risk Factors D015819:Substance Abuse, Intravenous D014057:Tomography, X-Ray Computed
pulmonary arterial enlargement pulmonary hypertension HIV computed tomography HCV coinfection persons with HIV