Simonetti Joseph A, Gingo Matthew R, Kingsley Lawrence, Kessinger Cathy, Lucht Lorrie, Balasubramani Gk, Leader Joseph K, Huang Laurence, Greenblatt Ruth M, Dermand John, Kleerup Eric C, Morris Alison
Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, WA, USA.
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
J AIDS Clin Res. 2014 Nov;5(11). doi: 10.4172/2155-6113.1000365.
Individuals with HIV infection commonly have pulmonary function abnormalities, including airflow obstruction and diffusion impairment, which may be more prevalent among recreational drug users. To date, the relationship between drug use and pulmonary function abnormalities among those with HIV remains unclear.
To determine associations between recreational drug use and airflow obstruction, diffusion impairment, and radiographic emphysema in men and women with HIV.
Cross-sectional analysis of pulmonary function and self-reported recreational drug use data from a cohort of 121 men and 63 women with HIV. Primary outcomes were the presence (yes/no) of: 1) airflow obstruction, (pre- or post-bronchodilator forced expiratory volume in 1 second/forced vital capacity<0.70); 2) moderate diffusion impairment (diffusing capacity for carbon monoxide <60% predicted); and 3) radiographic emphysema (>1% of lung voxels <-950 Hounsfield units). Exposures of interest were frequency of recreational drug use, recent (since last study visit) drug use, and any lifetime drug use. We used logistic regression to determine associations between recreational drug use and the primary outcomes.
HIV-infected men and women reported recent recreational drug use at 56.0% and 31.0% of their study visits, respectively, and 48.8% of men and 39.7% of women reported drug use since their last study visit. Drug use was not associated with airway obstruction or radiographic emphysema in men or women. Recent crack cocaine use was independently associated with moderate diffusion impairment in women (odds ratio 17.6; 95% confidence interval 1.3-249.6, p=0.03).
In this cross-sectional analysis, we found that recreational drug use was common among HIV-infected men and women and recent crack cocaine use was associated with moderate diffusion impairment in women. Given the increasing prevalence of HIV infection, any relationship between drug use and prevalence or severity of chronic pulmonary diseases could have a significant impact on HIV and chronic disease management.
感染艾滋病毒的个体通常存在肺功能异常，包括气流阻塞和弥散功能障碍，这在娱乐性吸毒者中可能更为普遍。迄今为止，艾滋病毒感染者中吸毒与肺功能异常之间的关系仍不清楚。
确定艾滋病毒感染的男性和女性中娱乐性吸毒与气流阻塞、弥散功能障碍和影像学肺气肿之间的关联。
对121名感染艾滋病毒的男性和63名感染艾滋病毒的女性队列的肺功能和自我报告的娱乐性吸毒数据进行横断面分析。主要结局为是否存在：1）气流阻塞（支气管扩张剂使用前或使用后1秒用力呼气量/用力肺活量<0.70）；2）中度弥散功能障碍（一氧化碳弥散量<预测值的60%）；3）影像学肺气肿（>1%的肺体素<-950亨氏单位）。感兴趣的暴露因素为娱乐性吸毒的频率、近期（自上次研究访视以来）吸毒情况以及任何终生吸毒情况。我们使用逻辑回归来确定娱乐性吸毒与主要结局之间的关联。
感染艾滋病毒的男性和女性分别在56.0%和31.0%的研究访视中报告近期有娱乐性吸毒行为，48.8%的男性和39.7%的女性报告自上次研究访视以来有吸毒行为。吸毒与男性或女性的气道阻塞或影像学肺气肿无关。近期使用快克可卡因与女性的中度弥散功能障碍独立相关（比值比17.6；95%置信区间1.3-249.6，p=0.03）。
在这项横断面分析中，我们发现娱乐性吸毒在感染艾滋病毒的男性和女性中很常见，近期使用快克可卡因与女性的中度弥散功能障碍有关。鉴于艾滋病毒感染率不断上升，吸毒与慢性肺病的患病率或严重程度之间的任何关系都可能对艾滋病毒和慢性病管理产生重大影响。
