Bronchial hyperresponsiveness in HIV patients with CD4 count less than 500 cells/μL

Background. HIV-infection is associated with immune system dysfunction primarily affecting CD4+ T cell, a source of pro-inflammatory mediators responsible for bronchial hyperresponsiveness (BHR). Objective: To compare BHR between HIV patients who had CD4 count less than 500 cells/mu L and healthy individuals. Methods: All subjects were randomized and evaluated by spirometry and methacholine inhalation challenge tests. Results: HIV patients had a significantly more frequent occurrence of chronic cough (57% vs. 31.4%), smoking history (36% vs. 15.2%), rhonchi on chest examination (4.7% vs. 0%), and restrictive lung defect by spirometry (65.7% vs. 38%). Although no statistical significance was detected, history of asthma was less frequent in HIV patients (4.7% vs. 6.3%). Methacholine challenge test representing BHR revealed positive results in 7.6% of HIV patients and 11.4% of healthy volunteers. Furthermore, HIV patients with CD4 cell count less than 200 cells/mu L had less frequent BHR compared with higher CD4 count group. However, these differences were not statistically significant. Conclusions: HIV patients with CD4 count less than 500 cells/mu L has lower prevalence of BHR than healthy subjects. Increased BHR in some HIV-individuals is in a mild range and not correlated with allergic symptoms.