Author/Authors :
Abdeen, Yazan Department of Pulmonary - Mercy Hospital - Fort Smith, USA , Al-Halawani, Moh’d Department of Pulmonary and Critical Care Medicine - SUNY Downstate Medical Center, USA , Kaako, Ahmad Department of Internal Medicine - Mercy Hospital - Fort Smith, USA , Ying Hao, Ingrid Fang Department of Internal Medicine - Saint Michael’s Medical Center, USA , Dazley, Jason Department of Infectious Diseases - Saint Michael’s Medical Center, Newark, USA , Katpally, Ram Department of Pulmonary Medicine - Saint Michael’s Medical Center, Newark, USA , Klukowicz, Alan Department of Pulmonary Medicine - Saint Michael’s Medical Center, Newark, USA , Miller, Richard Department of Pulmonary Medicine - Saint Michael’s Medical Center, Newark, USA , Slim, Jihad Department of Infectious Diseases - Saint Michael’s Medical Center, Newark, USA
Abstract :
Background: Protease inhibitors (PIs) are a vital part of the antiretroviral therapy. Long‑term use of PIs may cause lipodystrophy, a clinical syndrome characterized by peripheral lipoatrophy and central fat accumulation, which may increase the risk of developing obstructive sleep apnea (OSA) in HIV‑infected patients. We hypothesize that a longer duration of PIs’ use might be associated with increasing severity of OSA in HIV‑infected patients. Materials and Methods: This was a retrospective cohort study of HIV‑infected patients who were treated with PIs, who presented with symptoms suggestive of OSA, and underwent nocturnal polysomnography. The primary objective of the study is to evaluate the association between the duration of PIs’ use and the severity of OSA. The duration of PIs’ use measured in months was recorded for each patient. The primary outcome of interest was the apnea–hypopnea index (AHI) obtained at the time of the sleep study. Data were analyzed using univariate and multivariate linear regression between AHIs with PIs’ use as well as other predictors. Results: A total of 54 patients diagnosed with HIV and OSA were included in the study cohort for the analysis. Sleep study body mass index (BMI; P = 0.042) and change in BMI (ΔBMI; P = 0.027) were the only statistically significant independent predictors of AHI. The association between AHI and PIs’ use duration was found to be nonlinear and nonsignificant. Gender differences evaluation suggested possible duration‑related effect relationship between PIs and OSA severity among HIV‑infected men exposed to PIs within a 66‑month duration. Conclusion: We did not observe a significant association between PIs’ use duration and the severity of OSA.
Keywords :
HIV , lipodystrophy , obstructive sleep apnea , protease inhibitors
