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Increased rate of FEV1 decline in HIV patients despite effective treatment with HAART


Autoři: Gloria Sampériz aff001;  Francisco Fanjul aff002;  Jose Luis Valera aff002;  Meritxell Lopez aff003;  Ángel Rios aff003;  María Peñaranda aff002;  Antoni Campins aff002;  Melchor Riera aff002;  Alvar Agusti aff004
Působiště autorů: Hospital Universitario Miguel Servet, Zaragoza, Spain aff001;  Hospital Universitari Son Espases, Palma de Mallorca, Spain aff002;  Institut d`Investigació Sanitària Illes Balears, Palma de Mallorca, Spain aff003;  Respiratory Institute, Hospital Clinic, IDIBAPS, Univ. Barcelona, Barcelona, Spain aff004;  CIBER Enfermedades Respiratorias, Palma de Mallorca, Spain aff005
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0224510

Souhrn

Introduction

Previous studies have reported that the rate of FEV1 decline over time is increased in HIV patients but the mechanisms underlying this observation are unclear. Since current HIV treatment with Highly Active Antiretroviral Therapy (HAART) results in very good immune-viral control, we hypothesized that HAART should normalize the elevated rate of FEV1 decline previously reported in HIV patients if it was somehow related to the immune alterations caused by HIV, particularly in never smokers or quitters, since smoking is a well established risk factor for accelerated FEV1 decline in the general population.

Methods

We explored this hypothesis in a prospectively recruited cohort of 188 HIV (smoker and non-smoker) patients treated with HAART in Palma de Mallorca (Spain) and followed-up for 6 years. The cross-sectional characteristics of this cohort have been published elsewhere.

Results

We found that: (1) HAART resulted in good immune-viral control; (2) the rate of FEV1 decline remained abnormally elevated, even in non-smokers and quitters; and, (3) alcohol abuse during follow-up was related to FEV1 decline in these patients.

Discussion

Despite adequate immune-viral control by HAART, lung function decline remains increased in most HIV patients, even in non-smokers and quitters. Alcohol abuse is a preventable risk factor to decrease the accelerated FEV1 decline in this population.

Klíčová slova:

Viral load – HIV infections – Pulmonary function – Smoking habits – Medical risk factors – Marijuana – Highly-active antiretroviral therapy


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