Infectious Diseases Institute (IDI)

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Browsing Infectious Diseases Institute (IDI) by Author "Abelman, Rebecca A."
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    Sex and HIV differences in Preserved Ratio Impaired Spirometry (PRISm) among Ugandans postpneumonia
    (Oxford Academic, 2024) Abelman, Rebecca A. ; Fitzpatrick, Jessica ; Byanova, Katerina L. ; Zawedde, Josephine ; Sanyu, Ingvar ; Byanyima, Patrick ; Musisi, Emmanuel ; Hsieh, Jenny ; Zhang, Michelle ; Branchini, Jake ; Sessolo, Abdul ; Hunt, Peter W. ; Lalitha, Rejani ; Davis, Lucian J. ; Crothers, Kristina ; Worodria, William ; Huang, Laurence
    Background: Preserved ratio impaired spirometry (PRISm), defined as a normal ratio of forced expiratory volume in 1 second (FEV1) to forced vital capacity (≥0.70) with low FEV1 (<80% predicted), has been associated with increased mortality in the general population. Female sex has been associated with increased odds of PRISm in people without HIV. People with HIV (PWH) are at increased risk for lung function abnormalities, but whether HIV modifies the effect of sex on PRISm development is largely unknown. Methods: Adults with and without HIV underwent baseline followed by serial spirometry after completing therapy for pneumonia, predominantly tuberculosis (TB), in Kampala, Uganda. Using generalized estimating equations adjusted for age, body mass index, smoking, biomass fuel exposure, HIV, and TB status, we compared individuals with PRISm with those with normal spirometry. These models were stratified by HIV status. Results: Of 339 baseline participants, 153 (45%) were women; 129 (38%) had HIV, of whom 53% were women. Overall, 105/339 participants (31%) had PRISm at baseline. HIV was associated with lower odds of PRISm (adjusted odds ratio [aOR], 0.38; 95% CI, 0.21-0.68; P = .001). Female sex trended toward increased odds of PRISm among all participants (aOR, 1.65; 95% CI, 0.99-2.75; P = .052). The association between female sex and PRISm tended to be stronger among PWH (aOR, 3.16; 95% CI, 1.14-8.76; P = .03) than among those without HIV (aOR, 1.34; 95% CI, 0.73-2.45; P = .34); this study was underpowered to detect an HIV-sex interaction of this magnitude (P = .30). Conclusions: Among Ugandan adults who recovered from pneumonia, female sex was associated with increased odds and HIV with decreased odds of PRISm, suggesting independent sex and HIV effects on PRISm pathogenesis.
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    Sex modifies the risk of HIV-associated obstructive lung disease in Ugandans post-pneumonia
    (Wolters Kluwer, 2023) Abelman, Rebecca A. ; Fitzpatrick, Jessica ; Zawedde, Josephine ; Sanyu, Ingvar ; Byanyima, Patrick ; Kaswabuli, Sylvia ; Musisi, Emmanuel ; Hsieh, Jenny ; Gardner, Kendall ; Zhang, Michelle ; Byanova, Katerina L. ; Sessolo, Abdul ; Hunt, Peter W. ; Lalitha, Rejani ; Davis, Lucian J. ; Crothers, Kristina ; Worodria, William ; Huang, Laurence
    Objectives: Spirometric abnormalities are frequent, and obstructive lung disease (OLD) is a common comorbidity among people with HIV (PWH). HIV increases the risk of many comorbidities to a greater degree in women than in men. Few studies have evaluated whether sex modifies the HIV-associated risk of OLD. Design and methods: To evaluate the associations between sex and HIV with abnormal lung function, women and men with and without HIV underwent spirometric testing after completing therapy for pneumonia, including tuberculosis (TB), in Kampala, Uganda. OLD was defined as a postbronchodilator forced expiratory volume in the first second to forced vital capacity (FEV 1 /FVC) ratio less than 0.70. Associations between sex, HIV, and lung function were evaluated using multivariable regression models including sex-by-HIV interaction terms after adjusting for age, BMI, smoking status, and TB status. Results: Among 348 participants, 147 (42%) were women and 135 (39%) were HIV-positive. Sixteen (11%) women and 23 men (11%) had OLD. The HIV-sex interaction was significant for obstructive lung disease ( P = 0.04). In the adjusted stratified analysis, women with HIV had 3.44 (95% CI 1.11-12.0; P = 0.04) increased odds of having OLD compared with men with HIV. Women without HIV did not have increased odds of having OLD compared with men without HIV. Conclusion: HIV appears to increase the risk of OLD to a greater degree in women than in men in an urban Ugandan setting. The mechanistic explanation for this interaction by sex remains unclear and warrants further study.