IAS 2019 — Smokers with HIV: opportunistic infection history has mixed effect on long-term lung function


  • Myriam Vidal Valero
  • Conference Reports
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Takeaway

  • 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. 

Key results

  • 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).

Study design

  • Data for participants, ages 30-75 years, collected via health questionnaire and clinical test results. 

Limitations

  • Group allocation was skewed.
  • Subjective reporting of respiratory symptoms.
  • Self-reported OI history.

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