The use of advanced lung function tests and a new type of scan that identifies Obstructive Lung Disease in people living with HIV

This is a summary of a project carried out here in Sheffield by Dr Paul Collini, a Consultant and a Senior Lecturer in Infectious Diseases at Sheffield Teaching Hospitals and The University of Sheffield.

What is the project?

This research project aimed to find better ways to detect and understand lung problems in people living with HIV. The study used an advanced type of MRI scan to look at the lungs of people living with HIV who may also have obstructive lung disease.

Obstructive lung disease is when air does not get into (or out of) the whole lung effectively.

The goal of the project was to identify early signs of obstructive lung disease and understand how it progresses.

Who took part?

The study included 12 people living with HIV who accessed their care in Stonegrove and had various degrees of breathing difficulties. Some had known lung conditions (such as asthma), while others had no confirmed diagnosis even after standard lung function tests.

All people taking part were on antiretroviral therapy (ART) with undetectable HIV viral load.

What tests were carried out?

To measure lung function, the following tests were used:

Standard breathing tests that are normally used in the NHS
More specialised breathing tests that are not routine in the NHS.
A new type of MRI scan that uses a gas which is breathed in, to show where air is getting into the lungs. There are currently only two of these scanners in England; one in Sheffield and one in Oxford.

What did the tests show?

The new type of MRI scan revealed different types of lung issues.

Some participants showed signs of emphysema, a condition where the air sacs in the lungs are damaged.
Others had ventilation abnormalities, meaning parts of their lungs were not getting enough air.

These issues were detected even in participants who had normal results on standard lung function tests.

Dr Collini explained that some people with lung issues can still seem fine when taking standard breathing tests because the healthier areas of their lungs make up for the areas where there are problems.

An MRI scan of lungs without obstructive lung disease.

The white areas show air in all parts of both lungs.

An MRI scan of lungs which could have obstructive lung disease.

Some parts of the lungs don’t have white areas, meaning air is not getting to those parts of the lungs.

What were the experiences of people taking part in the study?

People living with HIV taking part in the study coped well with the tests. Some found the visits slightly long or had issues with parking near the hospital. Overall, the people in the study found the information and support offered helpful.

What do the results mean?

The findings suggest that MRI scans can detect early lung problems in people living with HIV before traditional tests show any issues.

Because the scans ‘map’ the lungs, they can be used to see in detail how someone’s lungs change over time.

This could lead to:

Earlier treatment and better management of lung disease in people living with HIV.
Developing specific screening tests for people living with HIV

What’s next?

The study supports further research to confirm these findings in a larger group of people and explore new ways to prevent and treat lung disease in people living with HIV.

If you are interested in finding out more or getting involved to help shape future research in HIV, please contact Dr Paul Collini (p.collini@sheffield.ac.uk) or Justine Salumbides (jcsalumbides1@sheffield.ac.uk)