Patients Susceptible to Lung Diseases

“Early in the epidemic, HIV was a different disease - with few effective drugs, the best that an HIV-positive patient could hope for was a relatively painless death after a brief period,” said researcher Syed Kadri who presents the new findings. “The long-term effects of HIV were therefore fairly obvious: death. But with the advent of a new class of anti-retroviral drugs called ‘highly active anti-retroviral therapy,’ the clinical picture of HIV has changed. The disease has gone from being an automatic death sentence to a chronic condition, and like all chronic conditions, it brings with it other complications that can seriously affect the lives of those who have it.”

Kadri and colleagues are directing a prospective study to evaluate declines in lung function among HIV-positive patients. The patients, mostly men in their 40s, half of whom were smokers, were assessed at baseline for two measures of respiratory status, FEV1 and DLCO, and had been followed for two years at the time of reporting. FEV1 is a measure of expiratory flow in one second, a standard gauge of lung capacity, whereas DLCO is a measurement of diffusing capacity of the lungs and is decreased in patients with emphysema.

At the end of two years, the 63 patients displayed marked declines in lung function, going from an average FEV1 of 88 percent predicted to 83.2 percent and a DLCO of 77.6 to 70.0. “This is the type of decline you might expect to see in elderly individuals who have a long history of smoking,” said Kadri.

“These results indicate that HIV-positive patients are more susceptible to lung-related problems than HIV-negative individuals and that HIV-positive smokers are even more susceptible to developing early emphysema. We do not know when these differences begin to manifest in HIV-positive individuals who smoke, but the severity is likely a function of the time that they have lived with the disease.”; Source: American Thoracic Society (ATS)