Objectives

The Lung HIV study was established to expedite the data and specimen collection results of eight different HIV and pulmonary studies operated under NHLBI. The project used these existing studies to create a foundation for future research and provide further insight on the relationship between pulmonary disease and HIV infection.

Background

As of 2011, approximately 33 million people have HIV. Antiretroviral therapy and similar clinical strategies have improved survival rates and turned HIV infection into a chronic disease. However, persistent loss of immunity from HIV infection results in increased development of comorbid diseases that significantly affect mortality. Many HIV-infected persons in resource-limited regions experience serious or fatal lung complications that are poorly characterized. Thus, the LUNG HIV Study was established as a collaborative multi-R01 consortium created to address missing links in the knowledge of HIV-associated pulmonary diseases.

Participants

Specific eligibility criteria varied according to the parameters of the individual protocols. However, all projects focused on populations with HIV infection and pulmonary conditions. Effort was made to recruit patients at the earliest possible time point in their clinical care.

Design

Eight clinical centers conducted their own separate research studies with unique cohorts and study designs. All studies were joined together to conduct multisite and group-level collaborative studies. There were six types of data that were collected and harmonized for the Lung HIV study: clinical data, laboratory data, pulmonary function testing data, qualitative and quantitative CT scan data and questionnaire data.
The individual research studies are as follows:

• Longitudinal Study of HIV-Associated Lung Infections in Soweto
• The Study of HIV Infection in the Etiology of Lung Disease (SHIELD)
• The Longitudinal Studies of HIV-Associated Bacterial Pneumonia
• Smoking Cessation and the Natural History of HIV-Associated Emphysema Prevalence
• International HIV-Associated Opportunistic Pneumonias (IHOP)
• Longitudinal Studies of HIV-1 Nef in Pulmonary Hypertension
• Prevalence and Pathogenesis of Pulmonary Disease in a Large Multi-Center HIV Cohort
• EXamination of HIV-Associated Lung Emphysema (EXHALE)

Conclusions

Lung diseases are a significant cause of morbidity and mortality in HIV-infected individuals, and the lung infections and complications associated with HIV infection are broad. Ongoing research within the Lung HIV Study seeks to characterize the lung complications occurring in HIV-infected individuals and to provide insights into pathogenesis of these complications.

Proc Am Thorac Soc. 2011 Jun 1; 8(3): 275–281.

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