Incident obstructive lung disease and mortality among people with HIV and a history of injecting drugs

Kalmin, Mariah M; Westreich, Daniel; Drummond, Brad; Sun, Jing; Mehta, Shruti H.; Kirk, Gregory D.

doi:10.1097/qad.0000000000002914

Cited by 3 publications

(3 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The Examinations of HIV-associated Lung Emphysema study demonstrated that decreased DL CO and FEV 1 and airflow obstruction were independent predictors of mortality (12). Finally, incident airflow obstruction was a risk factor for mortality in the AIDS Linked to the Intravenous Experience study (13). Our finding that only the adverse DL CO phenotype was associated with increased mortality further supports diffusion impairment as a marker of excess mortality risk in HIV.…”

Section: Discussionsupporting

confidence: 57%

“…Although smoking is more prevalent among PWH, human immunodeficiency virus (HIV) infection independently predicts airflow obstruction (1,2), gas exchange limitation (3)(4)(5), and emphysema (3,6). Among PWH, airflow and gas exchange abnormalities have been identified as independent risk factors for increased respiratory symptoms (7), worse respiratory health status (8), decreased functional capacity (6,9,10), and increased mortality (11)(12)(13).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Pulmonary Function Trajectories in People with HIV: Analysis of the Pittsburgh HIV Lung Cohort

Konstantinidis¹,

Qin²,

Fitzpatrick³

et al. 2022

Annals ATS

View full text Add to dashboard Cite

Rationale: Human immunodeficiency virus (HIV) infection is associated with chronic lung disease and impaired pulmonary function; however, longitudinal pulmonary function phenotypes in HIV are undefined.Objectives: To identify pulmonary function trajectories, their determinants, and outcomes.Methods: We used data from participants with HIV in the Pittsburgh HIV Lung Cohort with three or more pulmonary function tests between 2007 and 2020. We analyzed post-bronchodilator forced expiratory volume in 1 second (FEV 1 ), forced vital capacity (FVC), and FEV 1 /FVC, and diffusing capacity of the lung for carbon monoxide (DL CO ) using group-based trajectory modeling to identify subgroups of individuals whose measurements followed a similar pattern over time. We examined the association between participant characteristics and trajectories using multivariable logistic regression. In exploratory adjusted analyses restricted to individuals with available plasma cytokine data, we investigated the association between 18 individual standardized cytokine concentrations and trajectories. We compared mortality, dyspnea prevalence, respiratory health status, and 6-minute-walk distance between phenotypes.Results: A total of 265 participants contributed 1,606 pulmonary function measurements over a median follow-up of 8.1 years. We identified two trajectories each for FEV 1 and FVC: "low baseline, slow decline" and "high baseline, rapid decline." There were three trajectory groups for FEV 1 /FVC: "rapid decline," "moderate decline," and "slow decline." Finally, we identified two trajectories for DL CO : "baseline low" and "baseline high." The low baseline, slow decline FEV 1 and FVC, rapid decline, and moderate decline FEV 1 /FVC, and baseline low DL CO phenotypes were associated with increased dyspnea prevalence, worse respiratory health status, and decreased 6-minute-walk distance. The baseline low DL CO phenotype was also associated with worse mortality. Current smoking and pack-years of smoking were associated with the adverse FEV 1 , FEV 1 /FVC, and DL CO phenotypes. Detectable viremia was the only HIV marker associated with the adverse DL CO phenotype. C-reactive protein and endothelin-1 were associated with the adverse FEV 1 and FVC phenotypes, and endothelin-1 trended toward an association with the adverse DL CO phenotype.Conclusions: We identified novel, distinct longitudinal pulmonary function phenotypes with significant differences in characteristics and outcomes. These findings highlight the importance of lung dysfunction over time in people with HIV and should be validated in additional cohorts.

show abstract

Section: Discussionsupporting

confidence: 57%

mentioning

confidence: 99%

Pulmonary Function Trajectories in People with HIV: Analysis of the Pittsburgh HIV Lung Cohort

Konstantinidis¹,

Qin²,

Fitzpatrick³

et al. 2022

Annals ATS

View full text Add to dashboard Cite

show abstract

“…Other studies have estimated COPD prevalence, 3–5 incidence, 47 and mortality 48 49 among people who use illicit opioids, also finding a high health burden related to COPD. To our knowledge, this is the first study investigating treatment in this population.…”

Section: Discussionmentioning

confidence: 99%

Burden and treatment of chronic obstructive pulmonary disease among people using illicit opioids: matched cohort study in England

Lewer

Cox

Hurst

et al. 2022

bmjmed

View full text Add to dashboard Cite

ObjectiveTo understand the burden of chronic obstructive pulmonary disease among people who use illicit opioids such as heroin, and evaluate inequalities in treatment.DesignCohort study.SettingPatients registered at primary care practices in England.Participants106 789 patients in the Clinical Practice Research Datalink with illicit opioid use recorded between 2001 and 2018, and a subcohort of 3903 patients with a diagnosis of chronic obstructive pulmonary disease. For both cohorts, the study sampled a comparison group with no history of illicit opioids that was matched by age, sex, and general practice.Main outcome measuresIn the base cohort: diagnosis of chronic obstructive pulmonary disease and death due to the disease. In the subcohort: five treatments (influenza vaccine, pneumococcal vaccine, pulmonary rehabilitation, bronchodilators or corticosteroids, and smoking cessation support) and exacerbations requiring hospital admission.Results680 of 106 789 participants died due to chronic obstructive pulmonary disease, representing 5.1% of all cause deaths. Illicit opioid use was associated with 14.59 times (95% confidence interval 12.28 to 17.33) the risk of death related to chronic obstructive pulmonary disease, and 5.89 times (5.62 to 6.18) the risk of a diagnosis of the disease. Among patients with a new diagnosis, comorbid illicit opioid use was associated with current smoking, underweight, worse lung function, and more severe breathlessness. After adjusting for these differences, illicit opioids were associated with 1.96 times (1.82 to 2.12) times the risk of exacerbations requiring hospital admission, but not associated with a substantially different probability of the five treatments.ConclusionsDeath due to chronic obstructive pulmonary disease is about 15 times more common among people who use illicit opioids than the general population. This inequality does not appear to be explained by differences in treatment, but late diagnosis of the disease among people who use illicit opioids might contribute.

show abstract

HIV-associated lung disease

Konstantinidis

Crothers

Kunisaki

et al. 2023

Nat Rev Dis Primers

View full text Add to dashboard Cite

Incident obstructive lung disease and mortality among people with HIV and a history of injecting drugs

Cited by 3 publications

References 46 publications

Pulmonary Function Trajectories in People with HIV: Analysis of the Pittsburgh HIV Lung Cohort

Pulmonary Function Trajectories in People with HIV: Analysis of the Pittsburgh HIV Lung Cohort

Burden and treatment of chronic obstructive pulmonary disease among people using illicit opioids: matched cohort study in England

HIV-associated lung disease

Contact Info

Product

Resources

About