Association between obstructive lung disease and markers of HIV infection in a high-risk cohort

M. Bradley Drummond, Gregory D Kirk, Jacquie Astemborski, Mariah M. Marshall, Shruti Hemendra Mehta, John F. McDyer, Robert Howard Brown, Robert A Wise, Christian Merlo

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Abstract

Background: Evidence suggests an association between HIV infection and the presence of obstructive lung disease (OLD). However, the associations between specific markers of HIV infection and OLD remain unclear. A study was undertaken to determine the independent associations of HIV infection, CD4 cell count and plasma HIV viral load with the presence of OLD in an urban cohort. Methods: Clinical, laboratory and spirometric data from the AIDS Linked to the Intravenous Experience (ALIVE) study, an observational study of current and former injection drug users in Baltimore, Maryland, were analysed. Multivariable logistic regression models were generated to identify HIV infection indices independently associated with OLD. Results: Of 1077 participants (mean±SD age 48±8 years), 89% were African-American, 65% were men and 86% were current smokers. A total of 303 (28%) were HIV infected and 176 (16%) had spirometry-defined OLD. Higher viral load was independently associated with OLD. HIV-infected individuals with viral load >200 000 copies/ml had a 3.4-fold increase in the odds of OLD compared with HIV-negative participants (95% CI 1.24 to 9.39; p=0.02). The association between higher HIV viral load and OLD persisted after accounting for antiretroviral therapy use (OR 4.06, 95% CI 1.41 to 11.7; p=0.01). No association was observed between HIV serostatus or CD4 cell count and the presence of OLD. Conclusion: In a cohort at risk for OLD and HIV infection, high viral load but not CD4 cell count was associated with an increased prevalence of spirometry-defined OLD. These findings suggest that higher viral load may contribute mechanistically to the increased risk of OLD in patients with HIV infection.

Original languageEnglish (US)
Pages (from-to)309-314
Number of pages6
JournalThorax
Volume67
Issue number4
DOIs
StatePublished - Apr 2012

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Obstructive Lung Diseases
HIV Infections
Viral Load
HIV
CD4 Lymphocyte Count
Spirometry
Logistic Models
Baltimore
Drug Users
African Americans
Observational Studies
Acquired Immunodeficiency Syndrome

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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Association between obstructive lung disease and markers of HIV infection in a high-risk cohort. / Drummond, M. Bradley; Kirk, Gregory D; Astemborski, Jacquie; Marshall, Mariah M.; Mehta, Shruti Hemendra; McDyer, John F.; Brown, Robert Howard; Wise, Robert A; Merlo, Christian.

In: Thorax, Vol. 67, No. 4, 04.2012, p. 309-314.

Research output: Contribution to journalArticle

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abstract = "Background: Evidence suggests an association between HIV infection and the presence of obstructive lung disease (OLD). However, the associations between specific markers of HIV infection and OLD remain unclear. A study was undertaken to determine the independent associations of HIV infection, CD4 cell count and plasma HIV viral load with the presence of OLD in an urban cohort. Methods: Clinical, laboratory and spirometric data from the AIDS Linked to the Intravenous Experience (ALIVE) study, an observational study of current and former injection drug users in Baltimore, Maryland, were analysed. Multivariable logistic regression models were generated to identify HIV infection indices independently associated with OLD. Results: Of 1077 participants (mean±SD age 48±8 years), 89{\%} were African-American, 65{\%} were men and 86{\%} were current smokers. A total of 303 (28{\%}) were HIV infected and 176 (16{\%}) had spirometry-defined OLD. Higher viral load was independently associated with OLD. HIV-infected individuals with viral load >200 000 copies/ml had a 3.4-fold increase in the odds of OLD compared with HIV-negative participants (95{\%} CI 1.24 to 9.39; p=0.02). The association between higher HIV viral load and OLD persisted after accounting for antiretroviral therapy use (OR 4.06, 95{\%} CI 1.41 to 11.7; p=0.01). No association was observed between HIV serostatus or CD4 cell count and the presence of OLD. Conclusion: In a cohort at risk for OLD and HIV infection, high viral load but not CD4 cell count was associated with an increased prevalence of spirometry-defined OLD. These findings suggest that higher viral load may contribute mechanistically to the increased risk of OLD in patients with HIV infection.",
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T1 - Association between obstructive lung disease and markers of HIV infection in a high-risk cohort

AU - Drummond, M. Bradley

AU - Kirk, Gregory D

AU - Astemborski, Jacquie

AU - Marshall, Mariah M.

AU - Mehta, Shruti Hemendra

AU - McDyer, John F.

AU - Brown, Robert Howard

AU - Wise, Robert A

AU - Merlo, Christian

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AB - Background: Evidence suggests an association between HIV infection and the presence of obstructive lung disease (OLD). However, the associations between specific markers of HIV infection and OLD remain unclear. A study was undertaken to determine the independent associations of HIV infection, CD4 cell count and plasma HIV viral load with the presence of OLD in an urban cohort. Methods: Clinical, laboratory and spirometric data from the AIDS Linked to the Intravenous Experience (ALIVE) study, an observational study of current and former injection drug users in Baltimore, Maryland, were analysed. Multivariable logistic regression models were generated to identify HIV infection indices independently associated with OLD. Results: Of 1077 participants (mean±SD age 48±8 years), 89% were African-American, 65% were men and 86% were current smokers. A total of 303 (28%) were HIV infected and 176 (16%) had spirometry-defined OLD. Higher viral load was independently associated with OLD. HIV-infected individuals with viral load >200 000 copies/ml had a 3.4-fold increase in the odds of OLD compared with HIV-negative participants (95% CI 1.24 to 9.39; p=0.02). The association between higher HIV viral load and OLD persisted after accounting for antiretroviral therapy use (OR 4.06, 95% CI 1.41 to 11.7; p=0.01). No association was observed between HIV serostatus or CD4 cell count and the presence of OLD. Conclusion: In a cohort at risk for OLD and HIV infection, high viral load but not CD4 cell count was associated with an increased prevalence of spirometry-defined OLD. These findings suggest that higher viral load may contribute mechanistically to the increased risk of OLD in patients with HIV infection.

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