- In people living with HIV (PLWH) who smoke, a history of opportunistic infections (OIs) has limited influence on chronic long-term pulmonary outcomes.
Why this matters
- Smoking prevalence among PLWH is 2-3 times higher than in the unaffected population.
- Outpatient smoking prevalence among PLWH ranges from 39% to 59%.
- As PLWH are living longer, the higher smoking rates are associated with an increased incidence of COPD.
- The most common OIs were pneumonia and pulmonary tuberculosis.
- PLWH with pulmonary OI history were more likely to:
- Be older: mean 54.3 vs 49.2 years, P<.001 and>
- Have lower current and nadir CD4+ counts: mean 499 vs 658, P=.009, and 103 vs 213, P.001, respectively.
- OI history was tied to lower FEV1: 2.7 vs 3.1 L (P=.024).
- COPD rates were doubled with OI history: 29% vs 14% (P=.046), although association diminished with adjustment.
- With adjustment for age and current smoking, odds of pulmonary OI were not significantly associated with chronic breathing problems, total St. George Respiratory Questionnaire score, or FEV1/FVC .05).
- Data for participants, ages 30-75 years, collected via health questionnaire and clinical test results.
- Group allocation was skewed.
- Subjective reporting of respiratory symptoms.
- Self-reported OI history.