# Characterizing chronic lung disease in youth living with HIV: quantitative chest CT analyses

> **NIH NIH R03** · UNIVERSITY OF WASHINGTON · 2022 · $88,364

## Abstract

PROJECT SUMMARY
Chronic lung disease (CLD) has emerged globally as an important but incompletely understood comorbidity
among youth living with HIV (YLWH) in the contemporary antiretroviral therapy era. Among YLWH, CLD
encompasses multiple subtypes, including obliterative bronchiolitis, bronchiectasis and asthma. This
heterogeneity adds complexity to characterizing CLD subtypes using clinical data such as symptoms and
spirometry that can overlap. In the ongoing, longitudinal BREATHE II Study (K23 HL129888), which obtained
161 chest CTs among YLWH and in other chest CT imaging studies in YLWH, chest CT abnormalities are
common and often concomitant. Studies among YLWH have not fully incorporated this degree of heterogeneity
in examining or identifying CLD subtypes, limiting understanding of the types of CLD among YLWH. Chest
quantitative CT methods (quantCT) for CLD assessment are rapidly gaining importance as clinical and
research tools. Compared to visual assessment of chest CT and clinical characteristics, quantCT can improve
subtype characterization, prognostication and outcome prediction in CLDs. The BREATHE II Study, combined
with earlier pilot work, provides a unique opportunity to apply quantCT to expand and refine CLD subtyping in
the largest chest CT imaging cohort in YLWH to date. QuantCT metrics include static and functional lung
density, % parenchymal involvement by texture categories (e.g., ground glass, hyperlucency, reticulation) and
airway wall thickness. Overall objectives of this research are to determine clinical characteristics associated
with lung abnormalities defined by quantCT metrics in YLWH and determine whether these quantCT metrics
can identify subtypes of CLD that are associated with lung function growth trajectories over time. In addition to
low-dose inspiratory and expiratory CT scans of the entire lung fields, available data include repeat pre- and
post-bronchodilator spirometry, respiratory-focused questionnaires and physical exam data, and baseline
serum inflammatory biomarkers. This project will efficiently leverage these rigorously collected data and add
quantCT analyses to provide novel, innovative, objective metrics to improve CLD characterization in YLWH.
The study team has collective expertise in HIV-related lung disease, epidemiology, data science and quantCT,
ensuring successful completion of the following Aims: 1) Determine baseline clinical characteristics, including
spirometry, markers of HIV disease severity and serum biomarkers associated with lung abnormalities defined
by quantCT metrics in YLWH; 2) Identify CLD subtypes using unsupervised clustering methods, and determine
whether these subtypes are associated with lung function growth trajectories. Characterization of chest CT
using objective, operator-independent, quantitative measures may improve identification of CLD subtypes
among YLWH. Findings can provide insights into pathophysiologic mechanisms of CLD in YLWH and can
inform targeted, patien...

## Key facts

- **NIH application ID:** 10402042
- **Project number:** 1R03HL160251-01A1
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Engi Farouk Attia
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $88,364
- **Award type:** 1
- **Project period:** 2022-04-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10402042

## Citation

> US National Institutes of Health, RePORTER application 10402042, Characterizing chronic lung disease in youth living with HIV: quantitative chest CT analyses (1R03HL160251-01A1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10402042. Licensed CC0.

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