HIV+ Smokers Are at Double Risk

Highly active antiretroviral therapy has increased the life expectancy of people with HIV, but as they grow older they are encountering other health complications'among them, chronic obstructive pulmonary disease. But there's one obvious way to prevent or lessen COPD, say researchers: Don't smoke. COPD, a condition that interferes with breathing and is not fully reversible, is more common among HIV-positive individuals than those not infected. This led a group of French scientists to examine the factors that link HIV to COPD. They reviewed previous studies of the relationship between the virus and COPD and concluded that HIV itself likely affects lung function, as do various opportunistic infections associated with the virus. Some studies also indicated that drugs used to treat HIV caused obstruction of the bronchial tubes. But in their findings, published in the journal Respiratory Research, one fact particularly stands out. 'The prevalence of smoking among HIV-infected patients ranges from 40% to 70%, compared to about 25% in the general population in the United States,' they wrote. Before HAART became available, some studies indicated smoking or not smoking made little difference in death rates among people with HIV, the researchers noted. 'Since the advent of HAART,' they said, 'smoking has been identified as a significant risk factor for mortality among HIV-infected patients. More prolonged survival likely allows tobacco smoke to exert its deleterious effects and gives time for the corresponding diseases to become symptomatic.' Because of this, researchers say it's crucial that doctors and other care providers discourage their HIV-positive patients from smoking. They added that any HIVer with ongoing respiratory problems, whether a smoker or not, should undergo pulmonary function tests and lung imaging.