Faster lung function decline in people living with HIV despite adequate treatment: a longitudinal matched cohort study
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Faster lung function decline in people living with HIV despite adequate treatment : a longitudinal matched cohort study. / Thudium, Rebekka Faber; Ronit, Andreas; Afzal, Shoaib; Colak, Yunus; Forman, Julie Lyng; Mendo, Fernando; Chen, Fabian; Estrada, Vicente; Kumarasamy, Nagalingeswaran; Nordestgaard, Borge G.; Lundgren, Jens; Vestbo, Jørgen; Kunisaki, Ken M.; Nielsen, Susanne Dam; COCOMO Study Grp; INSIGHT START Pulm Substudy Grp; CGPS Study Grp.
In: Thorax, Vol. 78, No. 6, 2023.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Faster lung function decline in people living with HIV despite adequate treatment
T2 - a longitudinal matched cohort study
AU - Thudium, Rebekka Faber
AU - Ronit, Andreas
AU - Afzal, Shoaib
AU - Colak, Yunus
AU - Forman, Julie Lyng
AU - Mendo, Fernando
AU - Chen, Fabian
AU - Estrada, Vicente
AU - Kumarasamy, Nagalingeswaran
AU - Nordestgaard, Borge G.
AU - Lundgren, Jens
AU - Vestbo, Jørgen
AU - Kunisaki, Ken M.
AU - Nielsen, Susanne Dam
AU - COCOMO Study Grp
AU - INSIGHT START Pulm Substudy Grp
AU - CGPS Study Grp
PY - 2023
Y1 - 2023
N2 - Introduction Chronic lung disease is common among people living with HIV (PLWH). We hypothesised that PLWH receiving antiretroviral therapy (ART) have faster lung function decline than matched controls.Methods We performed a prospective matched cohort study by including ART-treated PLWH from the Copenhagen Co-morbidity in HIV Infection Study (n=705) and the INSIGHT Strategic Timing of Antiretroviral Treatment Pulmonary Substudy (n=425) and frequency matched population controls from the Copenhagen General Population Study (n=2895) in a 1:3 ratio. Eligible participants were >= 25 years old and had two spirometry tests separated by at least 2 years of follow-up. Forced expiratory volume in 1 s (FEV1) decline (mL/year) was compared between PLWH and controls using a linear mixed model adjusted for age, sex, ethnicity and smoking status. Effect modification by smoking was investigated in subgroup analyses.Results The majority of PLWH were virally suppressed (96.1%). The adjusted mean annual decline in FEV1 was faster in PLWH than in controls with 36.4 (95% CI 33.7 to 39.1) vs 27.9 (95% CI 26.9 to 28.8) mL/year, yielding a difference of 8.5 (95% CI 5.6 to 11.4) mL/year. The association between HIV and FEV1 decline was modified by smoking, with the largest difference in current smokers (difference: 16.8 (95% CI 10.5 to 23.0) mL/year) and the smallest difference in never-smokers (difference: 5.0 (95% CI 0.7 to 9.3) mL/year). FEV1 decline >40 mL/year was more prevalent in PLWH (adjusted OR: 1.98 (95% CI 1.67 to 2.34)).Conclusion Well-treated PLWH have faster lung function decline than controls and smoking seems to modify this association, suggesting that smoking may lead to more rapid lung function decline in PLWH than in controls.
AB - Introduction Chronic lung disease is common among people living with HIV (PLWH). We hypothesised that PLWH receiving antiretroviral therapy (ART) have faster lung function decline than matched controls.Methods We performed a prospective matched cohort study by including ART-treated PLWH from the Copenhagen Co-morbidity in HIV Infection Study (n=705) and the INSIGHT Strategic Timing of Antiretroviral Treatment Pulmonary Substudy (n=425) and frequency matched population controls from the Copenhagen General Population Study (n=2895) in a 1:3 ratio. Eligible participants were >= 25 years old and had two spirometry tests separated by at least 2 years of follow-up. Forced expiratory volume in 1 s (FEV1) decline (mL/year) was compared between PLWH and controls using a linear mixed model adjusted for age, sex, ethnicity and smoking status. Effect modification by smoking was investigated in subgroup analyses.Results The majority of PLWH were virally suppressed (96.1%). The adjusted mean annual decline in FEV1 was faster in PLWH than in controls with 36.4 (95% CI 33.7 to 39.1) vs 27.9 (95% CI 26.9 to 28.8) mL/year, yielding a difference of 8.5 (95% CI 5.6 to 11.4) mL/year. The association between HIV and FEV1 decline was modified by smoking, with the largest difference in current smokers (difference: 16.8 (95% CI 10.5 to 23.0) mL/year) and the smallest difference in never-smokers (difference: 5.0 (95% CI 0.7 to 9.3) mL/year). FEV1 decline >40 mL/year was more prevalent in PLWH (adjusted OR: 1.98 (95% CI 1.67 to 2.34)).Conclusion Well-treated PLWH have faster lung function decline than controls and smoking seems to modify this association, suggesting that smoking may lead to more rapid lung function decline in PLWH than in controls.
KW - COPD epidemiology
KW - Immunodeficiency
KW - Respiratory Measurement
KW - Viral infection
KW - Tobacco and the lung
KW - AIR-FLOW LIMITATION
KW - ANTIRETROVIRAL THERAPY
KW - RISK
KW - STANDARDIZATION
KW - INDIVIDUALS
KW - OBSTRUCTION
KW - SPIROMETRY
KW - DISEASE
KW - COPD
U2 - 10.1136/thorax-2022-218910
DO - 10.1136/thorax-2022-218910
M3 - Journal article
C2 - 36639241
VL - 78
JO - Thorax
JF - Thorax
SN - 0040-6376
IS - 6
ER -
ID: 336522151