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HIV infection may increase COPD risk
  By M. Mary Conroy
SEATTLE (Reuters Health) - Smokers who have HIV infection are more likely to develop chronic obstructive lung disease than smokers who are not infected with HIV, according to results reported at CHEST 2004, the 70th annual meeting of the American College of Chest Physicians.
Lead author, Dr. Kristina A. Crothers, of Yale University School of Medicine in New Haven said HIV-infected smokers with 40 pack-years of smoking "had a 5.5-fold increased risk for developing COPD, while 40 pack-year smokers who were not HIV positive had an odds ratio of 3."
Dr. Crothers noted that COPD risk increases with age and with the growth of HAART therapy "HIV patients are now living long enough to develop and die of comorbid diseases such as COPD." She declined to speculate as to the mechanism that increased COPD risk noting that more studies are needed to determine if "HAART therapy or HIV itself may be factors promoting COPD."
The take-home message to clinicians treating HIV patients is "that they should consider pulmonary function testing for any patients that develop respiratory symptoms."
The study enrolled 895 HIV-infected veterans and 653 veterans without HIV infection who were treated at five VA sites. Forty-five percent of the HIV-infected veterans were current smokers compared with 36% of the HIV- veterans (p < 0.001), but the uninfected veterans had a longer smoking history (an average of 20 pack years versus 16 pack years for the HIV-infected veterans.) Additionally, HIV-infected veterans were younger and more likely to be African-American, she said.
After adjusting for COPD risk factors such as age, race and pack-years smoking, "the HIV-infected veterans were 59% more likely to have COPD."


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