Department of Community Medicine, School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India.
BMC Public Health. 2024 Nov 22;24(1):3251. doi: 10.1186/s12889-024-20693-5.
People living with HIV (PLWH) are more vulnerable to infectious and non-infectious comorbidities due to chronic inflammation and immune dysfunction. Air pollution is a major global health risk, contributing to millions of deaths annually, primarily from cardiovascular and respiratory diseases. However, the link between air pollution and mortality risk in PLWH is underexplored. This systematic review assesses the association between exposure to pollutants such as particulate matter (PM), nitrogen dioxide (NO), sulfur dioxide (SO), ozone (O), and carbon monoxide (CO) and mortality risk in PLWH.
A systematic search of PubMed, Web of Science, and Embase was conducted for studies published up to August 2024. Eligibility criteria included cohort, case-control, and cross-sectional studies assessing air pollution exposure and mortality in PLWH. Nested-Knowledge software was used for screening and data extraction. The Newcastle-Ottawa Scale was applied for quality assessment. A narrative approach and tabular summarization were used for data synthesis and presentation.
Nine studies, mostly from China, demonstrated a significant association between long-term exposure to PM, PM, and PM and increased risks of AIDS-related and all-cause mortality in PLWH. Hazard ratios for mortality increased by 2.38-5.13% per unit increase in PM concentrations, with older adults (> 60), females, and those with lower CD4 counts (< 500 cells/µL) being more vulnerable. Short-term exposure to ozone and sulfur dioxide also increased mortality risks, particularly during the warm season and in older populations. Specific pollutants like ammonium (NH4⁺) and sulfate (SO4²⁻) had the strongest links to elevated mortality.
Air pollution, especially fine particulate matter and ozone, is associated with a higher risk of mortality in PLWH. Targeted interventions to reduce pollution exposure in vulnerable subgroups are crucial. Further research is needed to confirm these findings in diverse regions and develop effective mitigation strategies.
由于慢性炎症和免疫功能障碍，HIV 感染者（PLWH）更容易受到传染性和非传染性合并症的影响。空气污染是一个主要的全球健康风险，每年导致数百万人死亡，主要死于心血管和呼吸道疾病。然而，空气污染与 PLWH 死亡率之间的联系尚未得到充分探索。本系统评价评估了暴露于颗粒物（PM）、二氧化氮（NO）、二氧化硫（SO）、臭氧（O）和一氧化碳（CO）等污染物与 PLWH 死亡率之间的关联。
对截至 2024 年 8 月发表的 PubMed、Web of Science 和 Embase 进行了系统搜索。纳入标准包括评估 PLWH 空气污染暴露和死亡率的队列、病例对照和横断面研究。使用嵌套知识软件进行筛选和数据提取。应用纽卡斯尔-渥太华量表进行质量评估。采用叙述方法和表格总结进行数据综合和呈现。
9 项研究，主要来自中国，表明长期暴露于 PM、PM 和 PM 与 PLWH 中艾滋病相关和全因死亡率的增加显著相关。PM 浓度每增加一个单位，死亡率的危害比增加 2.38-5.13%，年龄较大（>60 岁）、女性和 CD4 计数较低（<500 个细胞/µL）的人更容易受到影响。臭氧和二氧化硫的短期暴露也增加了死亡率风险，特别是在温暖季节和老年人群中。特定污染物，如铵（NH4⁺）和硫酸盐（SO4²⁻）与死亡率升高的相关性最强。
空气污染，尤其是细颗粒物和臭氧，与 PLWH 死亡率升高相关。在脆弱亚组中，有必要采取有针对性的干预措施来减少污染暴露。需要进一步研究以确认这些发现在不同地区的适用性，并制定有效的缓解策略。
