Abstract
BackgroundPrevalence of HIV, smoking, and pulmonary infections in South Africa are high.ObjectivesWe investigated the role of smoking and HIV status on lung function.MethodsThis is a secondary analysis of a cross-sectional study conducted in South Africa. Data included demographics, pulmonary risk factors and a spirometry test to obtain the forced expiratory volume in one second (FEV1) and the ratio of FEV1/forced vital capacity (FVC). In the initial multivariable regression analysis, the effect of smoking on pulmonary function in HIV-positive adults was assessed. The analysis was repeated, assessing the influence of HIV status on lung function in both HIV-negative and HIV-positive smokers. The models were adjusted for age, sex, body mass index (BMI), time since HIV diagnosis, antiretroviral treatment (ART) use, occupational hazards, history of tuberculosis or pneumonia, indoor smoking and the presence of an indoor fireplace during childhood.ResultsThis study included 524 people living with HIV (PLWH, 66.7% female, mean age 40.9 years [s.d.; 9.4]) and 79 HIV-negative smokers (77.2% male, mean age 34.4 years [s.d.: 12.1]). Of the PLWH, 118 (22.5%) were past or current smokers and 406 (77.5%) were non-smokers. Smoking was not associated with changes in the FEV1 or FEV1/FVC ratio in multivariable regression analysis. In the second analysis, HIV status was also not associated with reduced pulmonary function following adjustment for confounders.ConclusionNeither smoking nor being HIV-positive was associated with decreased pulmonary function in this relatively young population. These findings should be confirmed in a longitudinal study, including an older population.
Highlights
Even though there is no cure for HIV infection, the use of antiretroviral treatment (ART) has resulted in a near normal life expectancy for people living with HIV (PLWH).[2,3]
Study Group II: This study aimed to investigate the interaction between HIV, ART and cardiopulmonary function in an urban South African population
One-third of the participants had been previously diagnosed with TB (33.0%), and approximately 10% had been previously diagnosed with pneumonia
Summary
HIV has infected over 75 million people, with over 32 million deaths reported worldwide since its emergence in the 1980s.1 Even though there is no cure for HIV infection, the use of antiretroviral treatment (ART) has resulted in a near normal life expectancy for people living with HIV (PLWH).[2,3]This increased life expectancy has resulted in an increase in age-related comorbid diseases, such as cardiovascular diseases, diabetes mellitus and cancers.[2,3] Untreated HIV is associated with an increased vulnerability to pulmonary infections, such as pneumonia and pulmonary tuberculosis (TB), resulting from the immune dysfunction caused by the virus.[2,4,5,6] ART restores immune function in PLWH, immunity does not return to normal levels and chronic immune activation persists. Even though there is no cure for HIV infection, the use of antiretroviral treatment (ART) has resulted in a near normal life expectancy for people living with HIV (PLWH).[2,3]. This increased life expectancy has resulted in an increase in age-related comorbid diseases, such as cardiovascular diseases, diabetes mellitus and cancers.[2,3]. ART restores immune function in PLWH, immunity does not return to normal levels and chronic immune activation persists This low-grade immune activation is manifested in the immune cells that reside in the lungs and may be responsible for HIV-related lung damage.[7]. Prevalence of HIV, smoking, and pulmonary infections in South Africa are high
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