Co-infected HIV/hepatitis patients compared with chronic liver patients and healthy individuals: respiratory assessment through surface electromyography and spirometry

Transplant Proc. 2014 Nov;46(9):3039-42. doi: 10.1016/j.transproceed.2014.07.015.

Abstract

Introduction: Co-infected HIV and hepatitis subjects are candidates for a liver transplantation because of progressive liver disease. Chronic liver disease, co-infected or not, requires assessment of respiratory function before liver transplantation. The respiratory evaluation of these 2 groups compared with healthy individuals can define deficits, and this can impair a full recovery after transplant surgery.

Objective: This study sought to compare the respiratory profile in co-infected patients with chronic liver disease who are candidates for liver transplantation with that of healthy subjects.

Methods: Through respiratory evaluation of flows and lung volumes (spirometry), muscle activity (surface electromyography), and maximum pressure (manovacuometer), 250 people were distributed into 3 groups: 14 patients with HIV and liver disease, 65 healthy subjects, and 171 patients with chronic liver disease. The mean age (years) was respectively 47.5 ± 6.2, 48.3 ± 14.1, and 52.9 ± 8.5. The average body mass index (kg/m(2)) of the groups was 24.6 ± 4.5, 26.0 ± 3.2, and 28.5 ± 5.3, respectively.

Results: There was a statistical difference among the groups in the root means square (RMS) rectus abdominis (μV) (P = .0016), RMS diaphragm (μV) (P = .0001), maximal inspiratory pressure (cmH2O) (P = .001), forced exhaled volume at the end of first second (%) (P = .002), and maximal mid expiratory flow 25% to 75% (%) (P = .0001) for the Kruskal-Wallis test. The multivariate analysis among the groups showed that the RMS diaphragm had a tendency to discriminate the co-infected subjects.

Conclusions: The co-infected HIV group showed a muscle deficit of diaphragm and rectus abdominis activity, and the liver disease group showed lower indexes in volumes and respiratory flows.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Coinfection / physiopathology*
  • Coinfection / surgery
  • Diaphragm / physiopathology
  • Electromyography
  • End Stage Liver Disease / physiopathology
  • End Stage Liver Disease / surgery*
  • Female
  • HIV Infections / epidemiology*
  • HIV Infections / physiopathology
  • Hepatitis / epidemiology*
  • Hepatitis / physiopathology
  • Hepatitis / surgery
  • Humans
  • Liver Diseases / epidemiology*
  • Liver Diseases / physiopathology
  • Liver Diseases / surgery
  • Liver Transplantation*
  • Lung / physiopathology
  • Male
  • Middle Aged
  • Muscle Strength
  • Rectus Abdominis / physiopathology
  • Respiratory Function Tests
  • Spirometry