Association between Pain, Pulmonary Function, and Respiratory Symptoms in People with HIV.

BACKGROUND People with HIV (PWH) experience chronic pain and respiratory symptoms, which are closely related in the general population. Pain may impact the impaired pulmonary function seen in PWH beyond its association with HIV alone. Our objective was to investigate the relationship of pain severity to pulmonary function, respiratory symptoms, and sleep disturbance in PWH. SETTING Study sites included the University of Pittsburgh, University of California San Francisco, and University of Washington. METHODS Pain, dyspnea, and sleep were assessed using the Brief Chronic Pain Questionnaire, St. George's Respiratory Questionnaire (SGRQ), and Pittsburgh Sleep Quality Index. Participants performed pre- and post-bronchodilator spirometry and six-minute walk test. Associations between pain severity, lung function, dyspnea, and sleep were assessed with bivariate and multiple quartile regression analysis adjusted for age, sex, race, BMI, and smoking status. RESULTS Of 159 PWH, median age was 56yr with 30.8% female. Two-thirds experienced pain in the past week, with 40.3% reporting chronic pain. Pain severity was higher with female sex (p=0.038), non-white race (p=0.005), current smoking (p=0.003), and lower CD4+ count (p=0.035). In adjusted analysis, higher pain severity was correlated with reduced post-bronchodilator FEV1 %predicted (p=0.008), reduced post-bronchodilator FVC %predicted (p=0.019), and COPD (p=0.032). Greater pain severity was strongly associated with higher SGRQ score (p<0.001) and sleep disturbance (p<0.001). CONCLUSION In PWH, pain is common and associated with airflow obstruction, dyspnea, and sleep disturbance. Future studies assessing pain severity and pulmonary function over time could clarify the direction of this association and the impact on quality of life.