HIV Diminishes Lung Function

We know that uncontrolled HIV can lead to a host of problems (see illustration). You can now count breathing among them.

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A new study has shown that if you have untreated HIV, you are much more prone to a rapid decline in lung function. Because we know that smoking negatively affects lung function, this finding adds urgency to the message that persons with HIV will benefit greatly from not smoking.

The study seems to corroborate soft-tissue organ damage by unchecked HIV, and is yet another argument buttressing early treatment and lowering viral levels among persons with HIV disease. From AIDSMEDS:

Though the study results from a Johns Hopkins University School of Medicine team note that people living with HIV—particularly those with viral loads not being kept in check with antiretroviral (ARV) therapy—have reduced lung strength and a more rapid loss of pulmonary function compared with HIV-negative controls, the researchers also point out that cigarette smoking was very common in the cohort studies and remains an important risk factor to contend with.

As explained by Michael Drummond, MD, of Johns Hopkins during his introductory remarks, HIV infection has been shown to increase the risk of obstructive lung diseases (OLD), such as emphysema and chronic bronchitis—both under the umbrella of chronic obstructive pulmonary disease (COPD)—and asthma.

According to a study reported in 2000, there was a greater prevalence of emphysema—documented using chest X-rays—in smokers living with HIV. And in a 2006 study, HIV infection was found to independently increase the risk of a COPD diagnosis by 47 percent.

More recently, in a study authored by Drummond and his colleagues in 2011, an HIV viral load in excess of 200,000 copies was associated with a 3.4-fold increase in the odds of having an OLD diagnosis using gold-standard pulmonary function tests. The cohort has enrolled more than 4,000 injection drug users, roughly a quarter of whom are people living with HIV.

People with uncontrolled HIV infection had a loss in lung function at a sharply higher rate than both HIV-negative people and those with good viral control. It means that if you smoke, you’re just going to make that loss of lung function happen faster. I quit smoking almost three years ago. In fact, I wrote about it right here.

There were a lot of reasons. But mostly, I quit because I wanted to consciously choose a healthy life. And I wanted to be able to credibly help others to do that, too. These facts from Nancy Reynolds study on HIV and smoking helped bring me out of the smokers’ corner for good:

The lungs of a person with HIV are more susceptible to cancer, emphysema, pneumonia,acute bronchitis and tuberculosis. This risk increases dramatically among HIV+ smokers.
The incidence of cancers, especially lung and cervical cancer are higher among HIV+ smokers and develop at a significantly younger age than the general population.
And the biggie: Smokers with HIV negate some of the effects of antiretroviaral medications by smoking. Thus, HIV+ smokers had a 36% greater chance of developing an AIDS-defining condition and a 53% higher risk of dying than HIV+ persons who did not smoke.

In the last few years after I quit smoking, my health has steadily improved. My cardiac function increased. My CD4 counts went up. My bilirubin counts went down- so did my bad cholesterol. All good things. I can exercise more without gasping, and I look good (if I do say so myself).

So, again, I’ll make a plea: I don’t want to be one of those newly-converted who scowls every time somebody lights up a cigarette. I really don’t. I understand how much fun smoking is, and how complicated. I just want you to have the facts. The very disturbing facts.

And maybe, if you’re a Person With HIV, they’ll hit you like they did me and you’ll improve the quality and length of your life. Just maybe.

And if you know someone who’s HIV+ who still smokes, show them this article- and ask them if they need support to quit. There are a lot of resources out there- and a lot of good reasons to choose from.

Even more now.