Pulmonary arterial enlargement in well-treated persons with HIV.

Background Pulmonary artery enlargement is a marker of pulmonary hypertension. We aimed to determine the proportion with pulmonary artery enlargement among well-treated persons with HIV (PWH) and uninfected controls. Methods PWH with a chest computed tomography were included from the ongoing Copenhagen Comorbidity in HIV Infection (COCOMO) study. Age and sex-matched uninfected controls were recruited from the Copenhagen General Population Study. Pulmonary artery enlargement was defined as a ratio of the diameter of the main pulmonary artery at the level of its bifurcation divided by the diameter of the ascending aorta (PA:A)>1. Results In total, 900 PWH were included and 44 (5%) had PA:A>1. After adjusting for age, sex and BMI, obesity (adjusted odds ratio, aOR: 4.33 [1.76-10.65], p=.001) and intravenous drug use (aOR: 4.90 [1.00-18.46], p=.027) were associated with higher odds of PA:A>1. Pulmonary indices or smoking were not associated with PA:A>1. HIV seropositivity was borderline associated with PA:A>1 (aOR: 1.89 [0.92-3.85], p=.081). Conclusions PA:A>1 was common in PWH. Obesity and intravenous drug use were independently associated with PA:A>1, but HIV-related factors were not. HIV serostatus was borderline associated with PA:A>1. Increased awareness may be appropriate in obese PWH and in those with intravenous drug use.