Brief Report: The Implications of Removing Race From Interpretation of Pulmonary Function Among Persons With or Without HIV
Year: 2024
Type: article
Abstract: BACKGROUND: Studies suggest that the use of race-specific pulmonary function reference equations may obscure racial inequities in respiratory health. Whether removing race from the interpretation of pulmonary function would influence analyses of HIV and pulmonary function is unknown. SETTING: Pulmonary function measurements from 1067 men (591 with HIV) in the Multicenter AIDS Cohort Study and 1661 women (1175 with HIV) in the Women's Interagency HIV Study were analyzed. METHODS: Percent-of-predicted values for spirometry and single-breath diffusing capacity of carbon monoxide (DLCO) measurements were generated with race-specific reference equations derived from the National Health and Nutrition Examination Survey and with the race-neutral application of reference equations derived from the Global Lung Function Initiative database. Regression models were used to evaluate the association between HIV and percent-of-predicted measures of pulmonary function. Alpaydin's F test was used to compare how well these values predicted self-reported respiratory health-related quality of life. RESULTS: Persons with HIV were observed to have significantly lower percent-of-predicted diffusing capacity for carbon monoxide (DLCO) than those without HIV but no significant differences in spirometric measures of pulmonary function, regardless of whether a race-specific or race-neutral approach was used. Among men, but not women, the race-neutral application of reference equations to generate percent-of-predicted DLCO values performed better for predicting respiratory-related quality of life. CONCLUSIONS: The race-neutral application of pulmonary function reference equations continues to identify lung function impairment in persons with or at risk for HIV and, for DLCO, may be superior to the use of race-specific reference equations in identifying clinically relevant impairments.
Authors: Richard J. Wang, Ken M. Kunisaki, Alison Morris, M. Bradley Drummond, Mehdi Nouraie, Laurence Huang, Phyllis C. Tien, Aaron D. Baugh, Igor Barjaktarevic, Neha Bhandari, Surya P. Bhatt, Gypsamber D'Souza, Margaret A. Fischl, Robert F. Foronjy, Robert L. Jensen, Deepa G. Lazarous, Ighovwerha Ofotokun, Divya Reddy, Valentina Stosor, Meredith C. McCormack, Sarath Raju
Institutions: University of California, San Francisco, University of Minnesota, Minneapolis VA Health Care System, Minneapolis VA Medical Center, University of Pittsburgh, University of North Carolina at Chapel Hill, San Francisco VA Medical Center, San Francisco VA Health Care System, University of California, Los Angeles, Cook County Health and Hospitals System, University of Alabama at Birmingham, Johns Hopkins University, University of Miami, SUNY Downstate Health Sciences University, University of Utah, Georgetown University, Emory University, Albert Einstein College of Medicine, Northwestern University
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Mental Health, National Institute on Drug Abuse, National Cancer Institute, National Institute on Deafness and Other Communication Disorders, National Institute of Nursing Research, National Institute of Allergy and Infectious Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Neurological Disorders and Stroke, National Institute of Environmental Health Sciences, National Institute of Dental and Craniofacial Research, National Institute on Minority Health and Health Disparities, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: G1116436001, G1480047325, Structural Determinants of Disease Progression in COPD, G2020100370, G2332834719, G4546684201, G5747858550, G647444367, G6710837446, G693265041, G7540634880, University of Pittsburgh MACS/WIHS CCS, UNC MACS/WIHS Combined Cohort Study Clinical Research Site, Data Analysis and Coordination Center for the MACS-WIHS Combined Cohort Study, Clinical Research Sites for the MACS/WIHS Combined Cohort Study (MACS/WIHS-CCS) - Baltimore/Wash DC Center
OpenAlex ID: W4404982968