Philip T. Diaz, MD; Mark A. King, MD; Eric R. Pacht, MD; Mark D. Wewers, MD; James E. Gadek, MD; Haikady N. Nagaraja, PhD; Janice Drake; Thomas L. Clanton, PhD
Acknowledgments: The authors thank Tina Bees and Valerie Wright for assistance in manuscript preparation.
Grant Support: By National Heart, Lung, and Blood Institute grants RO1-HL49730 and RO1HL53229 and by Clinical Research Center Grant 2MO1-RR0034.
Requests for Single Reprints: Philip T. Diaz, MD, Pulmonary and Critical Care Medicine, North 325 Means Hall, 1654 Upham Drive, Columbus, OH 43210-1228.
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Current Author Addresses: Drs. Diaz, Pacht, Wewers, Gadek, Drake, and Clanton: Pulmonary and Critical Care Division, Department of Internal Medicine, Ohio State University, N-325 Means Hall, 1654 Upham Drive, Columbus, OH 43210.
Dr. King: Department of Radiology, Ohio State University, N-325 Means Hall, 1654 Upham Drive, Columbus, OH 43210.
Dr. Nagaraja: Department of Statistics, Ohio State University, N-325 Means Hall, 1654 Upham Drive, Columbus, OH 43210.
Author Contributions: Conception and design: P.T. Diaz, M.A. King, E.R. Pacht, M.D. Wewers, J.E. Gadek, J. Drake, T.L. Clanton.
Analysis and interpretation of data: P.T. Diaz, M.A. King, E.R. Pacht, J.E. Gadek, H.N. Nagaraja, T.L. Clanton.
Drafting of the article: P.T. Diaz.
Critical revision of the article for important intellectual content: P.T. Diaz, M.A. King, M.D. Wewers, J.E. Gadek, H.N. Nagaraja, T.L. Clanton.
Final approval of the article: P.T. Diaz, M.A. King, E.R. Pacht, M.D. Wewers, J.E. Gadek, H.N. Nagaraja, J. Drake, T.L. Clanton.
Provision of study materials or patients: P.T. Diaz.
Statistical expertise: H.N. Nagaraja, T.L. Clanton.
Obtaining of funding: P.T. Diaz, M.D. Wewers.
Administrative, technical, or logistic support: P.T. Diaz.
Collection and assembly of data: M.A. King, J. Drake.
Previous uncontrolled reports have suggested that HIV-seropositive persons develop an accelerated form of emphysema.
To characterize the risk for emphysema in a stable HIV-seropositive outpatient population.
Controlled, cross-sectional analysis.
Midwestern urban community.
HIV-seropositive persons (n = 114) without AIDS-related pulmonary complications and HIV-seronegative controls (n = 44), matched for age and smoking history.
Measurement of pulmonary function, bronchoalveolar lavage, and high-resolution computed tomography of the chest.
The incidence of emphysema was 15% (17 of 114) in the HIV-seropositive group compared with 2% (1 of 44) in the HIV-seronegative group (P = 0.025). The incidence of emphysema in participants with a smoking history of 12 pack-years or greater was 37% (14 of 38 persons) in the HIV-seropositive group compared with 0% (0 of 14 persons) in the HIV-seronegative group (P = 0.011). The percentage of cytotoxic lymphocytes in lavage fluid was much higher in HIV-seropositive smokers with emphysema.
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.
Diaz PT, King MA, Pacht ER, Wewers MD, Gadek JE, Nagaraja HN, et al. Increased Susceptibility to Pulmonary Emphysema among HIV-Seropositive Smokers. Ann Intern Med. 2000;132:369–372. doi: 10.7326/0003-4819-132-5-200003070-00006
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Published: Ann Intern Med. 2000;132(5):369-372.
Cardiology, Chronic Obstructive Airway Disease, Coronary Risk Factors, HIV, Infectious Disease.
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