Increased Susceptibility to Pulmonary Emphysema among HIV-Seropositive Smokers

Diaz, Philip T.; King, Mark A.; Pacht, Eric R.; Wewers, Mark D.; Gadek, James E.; Nagaraja, Haikady N.; Drake, Janice; Clanton, Thomas L.

doi:10.7326/0003-4819-132-5-200003070-00006

Cited by 281 publications

(273 citation statements)

References 13 publications

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“…This organism has been reported to colonize 36% of lung tissues from patients with end-stage COPD versus 5% of specimens from healthy controls or those with less severe disease (Morris et al 2004). Smokers infected with Human Immuno-defi ciency Virus (HIV) also appear to have accelerated development of emphysema, particularly in those that also have high CD8 + lymphocyte counts in BAL fl uid (Diaz et al 2000). Pneumocystis colonization in lungs of rhesus macaques infected with Simian Immunodefi ciency Virus (SIV) generated CD8-lymphocyte and neutrophil predominant cellular inflammation in association with progressive airflow limitation and local increases in IL-8, IFN-γ, and TNF-α, reminiscent of the findings in emphysematous patients (Norris et al 2006).…”

Section: Microbial Peptide Antigensmentioning

confidence: 99%

Role of T-lymphocytes and pro-inflammatory mediators in the pathogenesis of chronic obstructive pulmonary disease

Gadgil

Duncan

2008

COPD

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Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the US and a major worldwide healthcare problem. The pathophysiologic mechanisms that drive development and progression of this disease are complex and only poorly understood. While tobacco smoking is the primary risk factor, other disease processes also appear to play a role. Components of the innate immune system (eg, macrophages and neutrophils) have long been believed to be important in the development of COPD. More recent evidence also suggests involvement of the adaptive immune system in pathogenesis of this disease. Here we will review the literature supporting the participation of T-cells in the development of COPD, and comment on the potential antigenic stimuli that may account for these responses. We will further explore the prospective contributions of T-cell derived mediators that could contribute to the infl ammation, alveolar wall destruction, and small airway fi brosis of advanced COPD. A better understanding of these complex immune processes will lead to new insights that could result in improved preventative and/or treatment strategies.

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Section: Microbial Peptide Antigensmentioning

confidence: 99%

Role of T-lymphocytes and pro-inflammatory mediators in the pathogenesis of chronic obstructive pulmonary disease

Gadgil

Duncan

2008

COPD

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“…In addition to an increased risk for infectious pulmonary diseases, HIV-infected persons appear to have an increased risk for several noninfectious pulmonary conditions, including chronic obstructive pulmonary disease (COPD), lung cancer, and pulmonary arterial hypertension. HIV infection has been associated with several different manifestations of COPD and airway abnormalities, including features of emphysema (32), chronic bronchitis (33), nonspecific airway abnormalities, and bronchial hyperresponsiveness (34,35). In one study of 114 HIV-infected persons compared with 44 age-, sex-, and smoking-matched HIV-uninfected control subjects, 15% of the HIV-infected persons had emphysema on CT scan, compared with only 2% of non-HIV-infected persons (P 5 0.025) (32).…”

Section: Spectrum Of Hiv-associated Lung Infections and Complicationsmentioning

confidence: 99%

“…HIV infection has been associated with several different manifestations of COPD and airway abnormalities, including features of emphysema (32), chronic bronchitis (33), nonspecific airway abnormalities, and bronchial hyperresponsiveness (34,35). In one study of 114 HIV-infected persons compared with 44 age-, sex-, and smoking-matched HIV-uninfected control subjects, 15% of the HIV-infected persons had emphysema on CT scan, compared with only 2% of non-HIV-infected persons (P 5 0.025) (32). Another study found that HIV infection was associated with a 50 to 60% increased odds of COPD diagnosis (36).…”

Section: Spectrum Of Hiv-associated Lung Infections and Complicationsmentioning

confidence: 99%

HIV-Associated Lung Infections and Complications in the Era of Combination Antiretroviral Therapy

Crothers

Thompson

Burkhardt

et al. 2011

Proceedings of the American Thoracic Society

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The spectrum of lung diseases associated with HIV is broad, and many infectious and noninfectious complications of HIV infection have been recognized. The nature and prevalence of lung complications have not been fully characterized since the Pulmonary Complications of HIV Infection Study more than 15 years ago, before antiretroviral therapy (ART) increased life expectancy. Our understanding of the global epidemiology of these diseases in the current ART era is limited, and the mechanisms for the increases in the noninfectious conditions, in particular, are not well understood. The Longitudinal Studies of HIV-Associated Lung Infections and Complications (Lung HIV) Study (ClinicalTrials.gov number NCT00933595) is a collaborative multi-R01 consortium of research projects established by the National Heart, Lung, and Blood Institute to examine a diverse range of infectious and noninfectious pulmonary diseases in HIV-infected persons. This article reviews our current state of knowledge of the impact of HIV on lung health and the development of pulmonary diseases, and highlights ongoing research within the Lung HIV Study.

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“…[2][3][4] The progression of smoking-induced emphysema is hastened in individuals with HIV infection as well. 5 Increased rates of lung cancer among individuals living with HIV/AIDS appear to be attributed to smoking rather than immunosuppression. 6 Of the estimated 70% of cigarette smokers in the general adult U.S. population who reported visiting a physician or other health care professional at least once within the preceding 12 months, only 37% reported having received ad- vice from their health care provider to quit smoking.…”

Section: Introduction Imentioning

confidence: 99%

Cigarette Smoking and the Desire to Quit Among Individuals Living with HIV

Mamary

Bahrs

Martinez

2002

AIDS Patient Care and STDs

138

135

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Among individuals living with human immunodeficiency virus (HIV), studies have found that smokers are at greater risk than nonsmokers to develop bacterial pneumonia, oral lesions and acquired immune deficiency syndrome (AIDS) dementia complex. Information is lacking re garding the prevalence of cigarette smoking among people living with HIV or about their in tentions to quit smoking. A survey was conducted with a sample of patients attending an HIV outpatient clinic at San Francisco General Hospital to assess the prevalence of cigarette smok ing and the level of interest in quitting. In total, 228 assessments were completed. Study re sults revealed a high percentage of smokers among our sample of individuals living with HIV compared to the percentage of smokers found in the general adult population. A total of 123 individuals (54%) reported that they smoked cigarettes. Men were more than twice as likely to have made previous attempts at smoking cessation than were woman. The majority of cig arette smokers (63%) reported that they were currently thinking about quitting. Respondents' preferences for types of smoking cessation methods are discussed, and recommendations are proposed for identifying and treating tobacco dependence in this population.

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Increased Susceptibility to Pulmonary Emphysema among HIV-Seropositive Smokers

Abstract: Infection with HIV accelerates the onset of smoking-induced emphysema. The results of this study support the emerging concept that cytotoxic lymphocytes may have an important role in emphysema pathogenesis.

Cited by 281 publications

References 13 publications

Role of T-lymphocytes and pro-inflammatory mediators in the pathogenesis of chronic obstructive pulmonary disease

Role of T-lymphocytes and pro-inflammatory mediators in the pathogenesis of chronic obstructive pulmonary disease

HIV-Associated Lung Infections and Complications in the Era of Combination Antiretroviral Therapy

Cigarette Smoking and the Desire to Quit Among Individuals Living with HIV

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