Article    Table of Contents                    Full Text of this article    PDF of this article (PDFs free after 6 months)    Summary for Patients    Figures/Tables List    Related articles in Annals  Services    Send comment/rapid response letter    Notify a friend about this article    Alert me when this article is cited    Add to Personal Archive    Download to Citation Manager    ACP Search                            Get Permissions  Google Scholar    Search for Related Content  PubMed Articles in PubMed by Author:    Diaz, P. T.    Clanton, T. L.    Related Articles in PubMed    PubMed Citation    PubMed

BRIEF COMMUNICATION

Increased Susceptibility to Pulmonary Emphysema among HIV-Seropositive Smokers

Philip T. Diaz, MD; Mark A. King, MD; Eric R. Pacht, MD; Mark D. Wewers, MD; James E. Gadek, MD; Haikady N. Nagaraja, PhD; Janice Drake; and Thomas L. Clanton, PhD

7 March 2000 | Volume 132 Issue 5 | Pages 369-372

Background: Previous uncontrolled reports have suggested that HIV-seropositive persons develop an accelerated form of emphysema.

Objective: To characterize the risk for emphysema in a stable HIV-seropositive outpatient population.

Design: Controlled, cross-sectional analysis.

Setting: Midwestern urban community.

Participants: HIV-seropositive persons (n = 114) without AIDS-related pulmonary complications and HIV-seronegative controls (n = 44), matched for age and smoking history.

Measurements: Measurement of pulmonary function, bronchoalveolar lavage, and high-resolution computed tomography of the chest.

Results: The incidence of emphysema was 15% (17 of 114) in the HIV-seropositive group compared with 2% (1 of 44) in the HIV-seronegative group (P = 0.025). The incidence of emphysema in participants with a smoking history of 12 pack-years or greater was 37% (14 of 38 persons) in the HIV-seropositive group compared with 0% (0 of 14 persons) in the HIV-seronegative group (P = 0.011). The percentage of cytotoxic lymphocytes in lavage fluid was much higher in HIV-seropositive smokers with emphysema.

Conclusions: Infection with HIV accelerates the onset of smoking-induced emphysema. The results of this study support the emerging concept that cytotoxic lymphocytes may have an important role in emphysema pathogenesis.

Author and Article Information

From Ohio State University, Columbus, Ohio.

Acknowledgments: The authors thank Tina Bees and Valerie Wright for assistance in manuscript preparation.

Grant Support: By National Heart, Lung, and Blood Institute grants RO1-HL49730 and RO1HL53229 and by Clinical Research Center Grant 2MO1-RR0034.

Requests for Single Reprints: Philip T. Diaz, MD, Pulmonary and Critical Care Medicine, North 325 Means Hall, 1654 Upham Drive, Columbus, OH 43210-1228.

Requests To Purchase Bulk Reprints (minimum, 100 copies): Reprints Coordinator; phone, 215-351-2657; e-mail, reprints{at}mail.acponline.org.

Current Author Addresses: Drs. Diaz, Pacht, Wewers, Gadek, Drake, and Clanton: Pulmonary and Critical Care Division, Department of Internal Medicine, Ohio State University, N-325 Means Hall, 1654 Upham Drive, Columbus, OH 43210.

Dr. King: Department of Radiology, Ohio State University, N-325 Means Hall, 1654 Upham Drive, Columbus, OH 43210.

Dr. Nagaraja: Department of Statistics, Ohio State University, N-325 Means Hall, 1654 Upham Drive, Columbus, OH 43210.

Author Contributions: Conception and design: P.T. Diaz, M.A. King, E.R. Pacht, M.D. Wewers, J.E. Gadek, J. Drake, T.L. Clanton.

Analysis and interpretation of data: P.T. Diaz, M.A. King, E.R. Pacht, J.E. Gadek, H.N. Nagaraja, T.L. Clanton.

Drafting of the article: P.T. Diaz.

Critical revision of the article for important intellectual content: P.T. Diaz, M.A. King, M.D. Wewers, J.E. Gadek, H.N. Nagaraja, T.L. Clanton.

Final approval of the article: P.T. Diaz, M.A. King, E.R. Pacht, M.D. Wewers, J.E. Gadek, H.N. Nagaraja, J. Drake, T.L. Clanton.

Provision of study materials or patients: P.T. Diaz.

Statistical expertise: H.N. Nagaraja, T.L. Clanton.

Obtaining of funding: P.T. Diaz, M.D. Wewers.

Administrative, technical, or logistic support: P.T. Diaz.

Collection and assembly of data: M.A. King, J. Drake.

Related articles in Annals:

Summaries for Patients
HIV Infection and Emphysema

Annals 2000 132: 369. [Full Text]  

Letters
Tobacco Use in HIV-Infected Women
Michael B. Steinberg, Joseph A. DeSimone, AND Diane Abatemarco

Annals 2002 136: W1. [Full Text]  

This article has been cited by other articles:

				I Petrache, K Diab, K S Knox, H L Twigg III, R S Stephens, S Flores, and R M Tuder HIV associated pulmonary emphysema: a review of the literature and inquiry into its mechanism Thorax, May 1, 2008; 63(5): 463 - 469. [Abstract] [Full Text] [PDF]

				R O'Donnell, D Breen, S Wilson, and R Djukanovic Inflammatory cells in the airways in COPD Thorax, May 1, 2006; 61(5): 448 - 454. [Abstract] [Full Text] [PDF]

				P. T. Diaz, M. D. Wewers, M. King, J. Wade, J. Hart, and T. L. Clanton Regional Differences in Emphysema Scores and BAL Glutathione Levels in HIV-Infected Individuals Chest, November 1, 2004; 126(5): 1439 - 1442. [Abstract] [Full Text] [PDF]

				A Boutten, M Bonay, S Laribe, G Leseche, Y Castier, V Lecon-Malas, M Fournier, G Durand, M Aubier, M Dehoux, et al. Decreased expression of interleukin 13 in human lung emphysema Thorax, October 1, 2004; 59(10): 850 - 854. [Abstract] [Full Text] [PDF]

				A. Morris, F. C. Sciurba, I. P. Lebedeva, A. Githaiga, W. M. Elliott, J. C. Hogg, L. Huang, and K. A. Norris Association of Chronic Obstructive Pulmonary Disease Severity and Pneumocystis Colonization Am. J. Respir. Crit. Care Med., August 15, 2004; 170(4): 408 - 413. [Abstract] [Full Text] [PDF]

				B. R. Vuillemenot, J. F. Rodriguez, and G. W. Hoyle Lymphoid Tissue and Emphysema in the Lungs of Transgenic Mice Inducibly Expressing Tumor Necrosis Factor-{alpha} Am. J. Respir. Cell Mol. Biol., April 1, 2004; 30(4): 438 - 448. [Abstract] [Full Text] [PDF]

				A. Elssner, J. E. Carter, T. M. Yunger, and M. D. Wewers HIV-1 Infection Does Not Impair Human Alveolar Macrophage Phagocytic Function Unless Combined With Cigarette Smoking Chest, March 1, 2004; 125(3): 1071 - 1076. [Abstract] [Full Text] [PDF]

				S. D. Message and S. L. Johnston Host defense function of the airway epithelium in health and disease: clinical background J. Leukoc. Biol., January 1, 2004; 75(1): 5 - 17. [Abstract] [Full Text] [PDF]

				A Agusti, W MacNee, K Donaldson, and M Cosio Hypothesis: Does COPD have an autoimmune component? Thorax, October 1, 2003; 58(10): 832 - 834. [Full Text]

				P. T. Diaz, M. D. Wewers, E. Pacht, J. Drake, H. N. Nagaraja, and T. L. Clanton Respiratory Symptoms Among HIV-Seropositive Individuals Chest, June 1, 2003; 123(6): 1977 - 1982. [Abstract] [Full Text] [PDF]

				M. B. Steinberg, J. A. DeSimone, and D. Abatemarco Tobacco Use in HIV-Infected Women Ann Intern Med, June 4, 2002; 136(11): W1 - W1. [Full Text] [PDF]

				J. M. BECK, M. J. ROSEN, and H. H. PEAVY Pulmonary Complications of HIV Infection . Report of the Fourth NHLBI Workshop Am. J. Respir. Crit. Care Med., December 1, 2001; 164(11): 2120 - 2126. [Full Text] [PDF]

				C. D. POIRIER, N. INHABER, R. G. LALONDE, and P. ERNST Prevalence of Bronchial Hyperresponsiveness Among HIV-Infected Men Am. J. Respir. Crit. Care Med., August 15, 2001; 164(4): 542 - 545. [Abstract] [Full Text] [PDF]

				C MAYAUD and J CADRANEL AIDS and the lung in a changing world Thorax, June 1, 2001; 56(6): 423 - 426. [Full Text]

				J. Majo, H. Ghezzo, and M.G. Cosio Lymphocyte population and apoptosis in the lungs of smokers and their relation to emphysema Eur. Respir. J., May 1, 2001; 17(5): 946 - 953. [Abstract] [Full Text] [PDF]

				Z. Wang, T. Zheng, Z. Zhu, R. J. Homer, R. J. Riese, H. A. Chapman , Jr., S. D. Shapiro, and J. A. Elias Interferon {{gamma}} Induction of Pulmonary Emphysema in the Adult Murine Lung J. Exp. Med., December 4, 2000; 192(11): 1587 - 1600. [Abstract] [Full Text] [PDF]

				Susceptibility to Emphysema Linked to HIV AIDS Clinical Care, May 1, 2000; 2000(501): 4 - 4. [Full Text]

				Accelerated Emphysema in HIV Journal Watch (General), March 10, 2000; 2000(310): 3 - 3. [Full Text]