Ringheim Hedda, Thudium Rebekka F, Jensen Jens-Ulrik S, Rezahosseini Omid, Nielsen Susanne D
Viro-Immunology Research Unit, Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Section of Respiratory Medicine, Department of Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Front Med (Lausanne). 2022 Sep 21;9:897773. doi: 10.3389/fmed.2022.897773. eCollection 2022.
Before introducing combination antiretroviral therapy (cART), a higher prevalence of emphysema in people living with HIV (PLWH) than in the background population was reported. This systematic literature review aimed to investigate the prevalence of emphysema in PLWH and to compare the prevalence between PLWH and controls in the current cART era. A systematic literature search was conducted in PubMed, EMBASE, Scopus, and Web of Science (WOS), searching for "human immunodeficiency virus (HIV)" and "emphysema" from January 1, 2000 to March 10, 2021. Eligible studies were published after the introduction of cART, included PLWH, and reported the prevalence of emphysema. A total of 17 studies were included, and nine studies also included controls. The weighted average prevalence of emphysema in PLWH was 23% (95% CI: 16-30). In studies including both PLWH and controls the weighted average prevalence were 22% (95% CI: 10-33) and 9.7% (95% CI: 2.3-17), respectively ( = 0.052). The prevalence of emphysema in never-smoking PLWH and controls was just reported in one study and was 18 and 4%, respectively ( < 0.01). Thirteen of the studies had a moderate risk of bias, mainly due to selection of patients. A tendency to higher prevalence of emphysema was found in PLWH in comparison to controls in the current cART era. However, in the included studies, the definition of emphysema varied largely. Thus, to have a clear overview of the prevalence, further studies with well-designed cohorts of PLWH and controls are warranted.
在引入联合抗逆转录病毒疗法（cART）之前，有报告称，与普通人群相比，艾滋病毒感染者（PLWH）的肺气肿患病率更高。本系统文献综述旨在调查PLWH中肺气肿的患病率，并比较当前cART时代PLWH与对照组之间的患病率。在PubMed、EMBASE、Scopus和科学网（WOS）中进行了系统的文献检索，检索2000年1月1日至2021年3月10日期间的“人类免疫缺陷病毒（HIV）”和“肺气肿”。纳入的研究为cART引入后发表的、纳入了PLWH并报告了肺气肿患病率的研究。共纳入17项研究，其中9项研究还纳入了对照组。PLWH中肺气肿的加权平均患病率为23%（95%CI：16-30）。在同时纳入PLWH和对照组的研究中，加权平均患病率分别为22%（95%CI：10-33）和9.7%（95%CI：2.3-17）（P = 0.052）。仅在一项研究中报告了从不吸烟的PLWH和对照组中肺气肿的患病率，分别为18%和4%（P<0.01）。13项研究存在中度偏倚风险，主要原因是患者选择。在当前cART时代，与对照组相比，PLWH中肺气肿患病率有升高趋势。然而，在所纳入的研究中，肺气肿的定义差异很大。因此，为了清楚了解患病率，有必要对PLWH和对照组进行设计良好的队列研究。
