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

PLoS One. 2019 Oct 29;14(10):e0224510. doi: 10.1371/journal.pone.0224510. eCollection 2019.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active / methods
  • CD4 Lymphocyte Count / methods
  • Cohort Studies
  • Cross-Sectional Studies
  • DNA-Binding Proteins / genetics
  • DNA-Binding Proteins / metabolism*
  • Female
  • Follow-Up Studies
  • HIV Infections / drug therapy
  • HIV Infections / metabolism*
  • HIV-1 / pathogenicity
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Smoking
  • Spain
  • Transcription Factors / genetics
  • Transcription Factors / metabolism*
  • Treatment Outcome
  • Viral Load / drug effects*

Substances

  • Anti-HIV Agents
  • DNA-Binding Proteins
  • FEV protein, human
  • Transcription Factors

Grants and funding

This work was financed through ABAMI (Balearic Association of Infectious Diseases).The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.