Does Lung Disease Affect Mortality in HIV?

Obstructive lung disease does not affect mortality among individuals with HIV, according to new research presented at the Conference on Retroviruses and Opportunistic Infections.

The research, authored by Dr Mariah M. Kalmin and colleagues, was presented on March 5 as a research poster.

It is well known that individuals with HIV have an increased prevalence of obstructive lung disease, regardless of smoking status. Therefore, for their study, Dr Kalmin and colleagues aimed to investigate the effect of obstructive lung disease on mortality among individuals with HIV.

To conduct their study, Dr Kalmin and colleagues analyzed data from the ALIVE study. Participants were HIV-positive and HIV-negative, had a history of injection drug use, and had at least one spirometry measure to assess OLD between 2007 and 2016. Participants were excluded if they reported never smoking or had obstructive lung disease at baseline.

Among 1216 participants, 272 (22.4%) had experienced incident obstructive lung disease, and 157 (12.9%) deaths were recorded over a median of 5 person-years of follow-up.

Overall, obstructive lung disease did not significantly affect mortality. In secondary analysis, which assessed effect measure modification by HIV, individuals with HIV who were exposed to obstructive lung disease had experienced an increased risk of mortality; However, obstructive lung disease had no effect on mortality among individuals without HIV.

“Although [obstructive lung disease] did not have a statistically significant effect on mortality after properly accounting for baseline as well as time-varying confounders, there was an apparent effect of [obstructive lung disease] among HIV-positive people with a history of injection drug use,” the researchers concluded.

“These results highlight the need for greater screening and management of [obstructive lung disease] among HIV-positive individuals. Further research is needed to determine if there are particular clinical characteristics of HIV-infection that mitigate the risk of death after the occurrence of [obstructive lung disease].”

—Amanda Balbi

Reference:

Kalmin MM, Drummond MB, Kirk GD, Mehta SH, Westreich D. Effect of obstructive lung disease on mortality among HIV+ persons who inject drugs. Paper presented at: Conference of Retroviruses and Opportunistic Infections 2019; Seattle, WA; March 4-7, 2019. https://www.croiconference.org/sessions/effect-obstructive-lung-disease-mortality-among-hiv-persons-who-inject-drugs. Accessed March 7, 2019.