Cigarette Smoking in HIV Infection Induces a Suppressive Inflammatory Environment in the Lung

Abstract

Lung lymphocyte numbers are frequently increased in human immunodeficiency virus (HIV)-infected individuals in the absence of lung infection, and may play a critical role in viral surveillance and protection against new infections. In this context, cigarette smoking by HIV-infected individuals has been associated with a relative increase in the peripheral blood CD4(+) T-lymphocyte count as compared with that of nonsmokers. Because lung defense is local, the aim of the present study was to determine whether cigarette smoking had a significant impact on local lung defenses in HIV-infected individuals. The numbers and subtypes of bronchoalveolar lymphocytes and the ability of lung lavage cells to produce proinflammatory cytokines were compared in 58 smokers and 34 nonsmokers. In contrast to a trend toward an increase in peripheral blood CD4(+) cell counts among nonsmokers, smokers had significant depressions in both the percentage and absolute numbers of CD4(+) and CD8(+) cells in their bronchoalveolar lavage fluid (BALF). A decrease in CD4(+)/CD8(+) cell ratios was also seen with smoking. In addition, production of both interleukin-1beta (IL-1beta) and tumor necrosis factor-alpha (TNF-alpha) was suppressed with cigarette smoking. These observations show that cigarette smoking is associated with suppression in localized lung defenses, and suggest that smoking cessation may have a positive impact on lung defenses in HIV-infected smokers.

Cigarette Smoking and Lower Respiratory Tract Infection

“…Airways and lung parenchyma. Bronchoalveolar lavage studies have demonstrated a marked decrease in the absolute number of CD4+ cells, and an increase in CD8+ cells with a lower CD4+/CD8+ cell ratio in moderate smokers vs nonsmokers (Leatherman et al, 1984;Costabel et al, 1986;Wewers et al, 1998). No significant changes in these variables in the peripheral blood were found in this population of moderate smokers, in contrast with the www.intechopen.com Bronchitis 70 findings in heavy smokers discussed previously.…”

Prevalência e fatores associados à tuberculose em pacientes soropositivos para o vírus da imunodeficiência humana em centro de referência para tratamento da síndrome da imunodeficiência adquirida na região sul do Rio Grande do Sul

“…(21) This difference between HIV-infected patients and the general population has been reported in other studies in which the prevalence of HIV+ smokers ranged from 31% to 88%. (22)(23)(24) This high prevalence might be related to the great number of people with a history of illicit drug use, which has been strongly correlated with smoking.…”

Cigarette Smoking among HIV+ Men and Women: Examining Health, Substance Use, and Psychosocial Correlates across the Smoking Spectrum

“…We hypothesized that smoking among HIV+ people would be associated with markers of HIV disease progression (e.g., CD4 count, viral load). There is mixed support for the association between smoking and a decrease in CD4 count, with some research suggesting that there is no association (Gritz et al, 2004), and other studies finding decrements in CD4 counts as a function of smoking status (Royce & Winkelstein, 1990;Wewers et al, 1998). In a large-scale longitudinal study, Feldman et al (2006) found that HIV+ female smokers -who were prescribed antiretroviral therapy (HAART) -had poorer immunologic and viral responses.…”