HIV is an independent risk factor for lung disease, according to new data reported Wednesday, March 7, at the 19th Conference on Retroviruses and Opportunistic Infections. Though the study results from a Johns Hopkins University School of Medicine team note that people living with HIV—particularly those with viral loads not being kept in check with antiretroviral (ARV) therapy—have reduced lung strength and a more rapid loss of pulmonary function compared with HIV-negative controls, the researchers also point out that cigarette smoking was very common in the cohort studies and remains an important risk factor to contend with.
As explained by Michael Drummond, MD, of Johns Hopkins during his introductory remarks, HIV infection has been shown to increase the risk of obstructive lung diseases (OLD), such as emphysema and chronic bronchitis—both under the umbrella of chronic obstructive pulmonary disease (COPD)—and asthma.
According to a study reported in 2000, there was a greater prevalence of emphysema—documented using chest X-rays—in smokers living with HIV. And in a 2006 study, HIV infection was found to independently increase the risk of a COPD diagnosis by 47 percent.
More recently, in a study authored by Drummond and his colleagues in 2011, an HIV viral load in excess of 200,000 copies was associated with a 3.4-fold increase in the odds of having an OLD diagnosis using gold-standard pulmonary function tests. The cohort has enrolled more than 4,000 injection drug users, roughly a quarter of whom are people living with HIV.