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
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.
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 (nÂ =Â 114) without AIDS-related pulmonary complications and HIV-seronegative controls (nÂ =Â 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 (PÂ =Â 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 (PÂ =Â 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.
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HIV, Infectious Disease.
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