Alain Makinson1,2, Maurice Hayot3, Sabrina Eymard-Duvernay1, Céline Ribet4, François Raffi5, Gilles Pialoux6, David Zucman7, Isabelle Poizot-Martin8, Fabrice Bonnet9, Sophie Abgrall10, Pierre Tattevin11, Antoine Cheret12, Tristan Ferry13, Jean-Marc Mauboussin14, Lucie Marchand15, Claire Rouzaud16, Jacques Reynes1,2, Marie Zins4, Vincent Le Moing1,2. 1. Infectious and Tropical Diseases Department, University Hospital Montpellier. 2. UMI 233/INSERMU1175, IRD, University Montpellier. 3. Department of Clinical Physiology, INSERM U-1046, University Hospital Montpellier 1, University of Montpellier, Montpellier. 4. UMS 11 INSERM-UVSQ, 'Cohortes épidémiologiques en Population', Villejuif. 5. CIC 1413, INSERM, University Hospital, Nantes. 6. Infectious and Tropical Diseases Department, University Hospital Tenon, UPMC, Paris. 7. HIV Department, AP-HP, Foch Hospital Suresnes, Suresnes. 8. Immuno-Hematology Clinic, APHM Sainte-Marguerite Hospital, Aix-Marseille University/SESSTIM, Marseille. 9. Internal Medicine and Infectious Diseases Department, INSERM U1219, University Hospital Bordeaux, Bordeaux. 10. Department of Internal Medicine, AP-HP, Antoine Béclère Hospital, Clamart. 11. Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes. 12. Infectious Diseases Department, Tourcoing Hospital, Tourcoing. 13. University Hospital de la Croix Rousse, Lyon. 14. Infectious and Tropical Diseases Unit, Nîmes University Hospital, Nîmes. 15. France Recherche Nord et Sud Sida-HIV et Hépatites. 16. Department of Infectious Diseases and Tropical Medicine, Infectiology Centre Necker-Pasteur, AP-HP, Necker-Enfants Malades Hospital, Paris, France.
Abstract
OBJECTIVE: To explore whether airway obstruction is associated with HIV in a cohort of HIV-infected and uninfected smokers. METHODS: 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. RESULTS: 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. CONCLUSION: Our study found a significant association of airway obstruction with HIV status in smokers aged more than 40 years with previous immunodeficiency.
OBJECTIVE: To explore whether airway obstruction is associated with HIV in a cohort of HIV-infected and uninfected smokers. METHODS: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. RESULTS: 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. CONCLUSION: Our study found a significant association of airway obstruction with HIV status in smokers aged more than 40 years with previous immunodeficiency.
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