To explore whether airway obstruction is associated with HIV in a cohort of HIV-infected and uninfected smokers.
People living with HIV (PLWHIV) participated in the ANRS EP48 HIV CHEST study, an early lung cancer diagnosis study with low-dose chest tomography. HIV-uninfected study participants were from the CONSTANCES cohort. Inclusion criteria were an age greater than 40 years, a smoking history of at least 20 pack-years, and for PLWHIV, a CD4+ T-lymphocyte nadir less than 350/μl and last CD4+ cell count more than 100 cells/μl. Two randomly selected HIV-uninfected study participants were matched by age and sex with one PLWHIV. Prebronchodilatator forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio was the primary outcome, and association of FEV1/FVC ratio less than 0.70 and FEV1 less than 80% of the theoretical value, as a proxy of chronic obstructive pulmonary disease, the secondary outcome.
In total, 351 PLWHIV and 702 HIV-uninfected study participants were included. Median age was 50 years, and 17% of study participants were women. Plasma HIV RNA was less than 50 copies/ml in 89% of PLWHIV, with a median CD4+ cell count of 573 cells/μl. HIV (β −2.19), age (per 10 years increase; β −2.81), tobacco use (per 5 pack-years increase; β −0.34), and hepatitis C virus serology (β−2.50) were negatively associated with FEV1/FVC. HIV [odds ratio (OR: 1.72)], age (per 10 years increase; OR 1.77), and tobacco use (per 5 pack-years increase; OR 1.11) were significantly associated with the secondary outcome.
Our study found a significant association of airway obstruction with HIV status in smokers aged more than 40 years with previous immunodeficiency.
aInfectious and Tropical Diseases Department, University Hospital Montpellier
bUMI 233/INSERMU1175, IRD, University Montpellier
cDepartment of Clinical Physiology, INSERM U-1046, University Hospital Montpellier 1, University of Montpellier, Montpellier
dUMS 11 INSERM-UVSQ, ‘Cohortes épidémiologiques en Population’, Villejuif
eCIC 1413, INSERM, University Hospital, Nantes
fInfectious and Tropical Diseases Department, University Hospital Tenon, UPMC, Paris
gHIV Department, AP-HP, Foch Hospital Suresnes, Suresnes
hImmuno-Hematology Clinic, APHM Sainte-Marguerite Hospital, Aix-Marseille University/SESSTIM, Marseille
iInternal Medicine and Infectious Diseases Department, INSERM U1219, University Hospital Bordeaux, Bordeaux
jDepartment of Internal Medicine, AP-HP, Antoine Béclère Hospital, Clamart
kInfectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes
lInfectious Diseases Department, Tourcoing Hospital, Tourcoing
mUniversity Hospital de la Croix Rousse, Lyon
nInfectious and Tropical Diseases Unit, Nîmes University Hospital, Nîmes
oFrance Recherche Nord et Sud Sida-HIV et Hépatites
pDepartment of Infectious Diseases and Tropical Medicine, Infectiology Centre Necker-Pasteur, AP-HP, Necker-Enfants Malades Hospital, Paris, France.
Correspondence to Alain Makinson, MD, PhD, University Hospital Montpellier, 80 avenue Augustin Fliche, 34295 Montpellier, Cedex 5, France. E-mail: email@example.com
Received 7 July, 2017
Revised 20 September, 2017
Accepted 30 September, 2017