Bronchial dilatation in patients with HIV infection: CT assessment and correlation with pulmonary function tests and findings at bronchoalveolar lavage

OBJECTIVE. Symptoms of airway disease occur in patients infected with HIV, and bronchiectasis has been reported In patients with AIDS, We evaluated thin-section thoracic CT scans in HIV-positive individuals for bronchial dilatation and correlated imaging findings with pulmonary function abnormalities and findings at bronchoalveolar lavage (BAL). SUBJECTS AND METHODS. Sixty-one subjects, 50 of whom were HIV-positive and 11 of whom were HIV-negative, underwent thin-section CT, BAL, and pulmonary function tests, Two radiologists evaluated the CT scans on two separate occasions for bronchial dilatation in each lobe. BAL and pulmonary function test data in the subjects with bronchial dilatation were compared with such data in subjects with normal bronchi seen on CT scans. RESULTS, Eighteen of the 50 HIV-positive subjects and none of the HIV-negative subjects had bronchial dilatation revealed by CT. Subjects with bronchial dilatation revealed by CT had significantly higher BAL neutrophil counts (p = .014) and significantly lower diffusing capacity (p = .003) than did subjects with normal bronchi revealed by CT. CONCLUSION. Bronchial dilatation is commonly revealed by CT scans of HIV-positive individuals. The association of elevated levels of BAL neutrophils and decreased diffusing capacity with bronchial dilatation that we found in this study suggests that the neutrophil may be associated with airway damage and lung destruction in patients who are infected with HIV.