HIV 与气道阻塞有关：一项匹配对照研究。

HIV is associated with airway obstruction: a matched controlled study.

机构信息

Infectious and Tropical Diseases Department, University Hospital Montpellier.

UMI 233/INSERMU1175, IRD, University Montpellier.

出版信息

AIDS. 2018 Jan 14;32(2):227-232. doi: 10.1097/QAD.0000000000001691.

DOI:10.1097/QAD.0000000000001691

PMID:29135582

Abstract

OBJECTIVE

To explore whether airway obstruction is associated with HIV in a cohort of HIV-infected and uninfected smokers.

METHODS

People living with HIV (PLWHIV) participated in the ANRS EP48 HIV CHEST study, an early lung cancer diagnosis study with low-dose chest tomography. HIV-uninfected study participants were from the CONSTANCES cohort. Inclusion criteria were an age greater than 40 years, a smoking history of at least 20 pack-years, and for PLWHIV, a CD4 T-lymphocyte nadir less than 350/μl and last CD4 cell count more than 100 cells/μl. Two randomly selected HIV-uninfected study participants were matched by age and sex with one PLWHIV. Prebronchodilatator forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio was the primary outcome, and association of FEV1/FVC ratio less than 0.70 and FEV1 less than 80% of the theoretical value, as a proxy of chronic obstructive pulmonary disease, the secondary outcome.

RESULTS

In total, 351 PLWHIV and 702 HIV-uninfected study participants were included. Median age was 50 years, and 17% of study participants were women. Plasma HIV RNA was less than 50 copies/ml in 89% of PLWHIV, with a median CD4 cell count of 573 cells/μl. HIV (β -2.19), age (per 10 years increase; β -2.81), tobacco use (per 5 pack-years increase; β -0.34), and hepatitis C virus serology (β-2.50) were negatively associated with FEV1/FVC. HIV [odds ratio (OR: 1.72)], age (per 10 years increase; OR 1.77), and tobacco use (per 5 pack-years increase; OR 1.11) were significantly associated with the secondary outcome.

CONCLUSION

Our study found a significant association of airway obstruction with HIV status in smokers aged more than 40 years with previous immunodeficiency.

摘要

目的

探讨在一组 HIV 感染者和未感染者吸烟者中，气道阻塞是否与 HIV 相关。

方法

HIV 感染者（PLWHIV）参与了 ANRS EP48 HIV CHEST 研究，这是一项使用低剂量胸部 CT 进行早期肺癌诊断的研究。HIV 未感染者来自 CONSTANCES 队列。纳入标准为年龄大于 40 岁、吸烟史至少 20 包年，以及 PLWHIV 的 CD4 T 淋巴细胞最低点小于 350/μl，最后一次 CD4 细胞计数大于 100 个/μl。随机选择 2 名 HIV 未感染者与 1 名 PLWHIV 进行年龄和性别匹配。用力呼气 1 秒（FEV1）与用力肺活量（FVC）之比为主要结局，FEV1/FVC 比值小于 0.70 和 FEV1 小于理论值的 80%（慢性阻塞性肺疾病的替代指标）为次要结局。

结果

共纳入 351 名 PLWHIV 和 702 名 HIV 未感染者。中位年龄为 50 岁，17%的研究参与者为女性。89%的 PLWHIV 的血浆 HIV RNA 小于 50 拷贝/ml，中位 CD4 细胞计数为 573 个/μl。HIV（β-2.19）、年龄（每增加 10 岁；β-2.81）、吸烟（每增加 5 包年；β-0.34）和丙型肝炎病毒血清学（β-2.50）与 FEV1/FVC 呈负相关。HIV[比值比（OR）：1.72]、年龄（每增加 10 岁；OR 1.77）和吸烟（每增加 5 包年；OR 1.11）与次要结局显著相关。