The Impact of HAART on the Respiratory Complications of HIV Infection: Longitudinal Trends in the MACS and WIHS Cohorts
Year: 2013
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: To review the incidence of respiratory conditions and their effect on mortality in HIV-infected and uninfected individuals prior to and during the era of highly active antiretroviral therapy (HAART). DESIGN: Two large observational cohorts of HIV-infected and HIV-uninfected men (Multicenter AIDS Cohort Study [MACS]) and women (Women's Interagency HIV Study [WIHS]), followed since 1984 and 1994, respectively. METHODS: Adjusted odds or hazards ratios for incident respiratory infections or non-infectious respiratory diagnoses, respectively, in HIV-infected compared to HIV-uninfected individuals in both the pre-HAART (MACS only) and HAART eras; and adjusted Cox proportional hazard ratios for mortality in HIV-infected persons with lung disease during the HAART era. RESULTS: Compared to HIV-uninfected participants, HIV-infected individuals had more incident respiratory infections both pre-HAART (MACS, odds ratio [adjusted-OR], 2.4; 95% confidence interval [CI], 2.2-2.7; p<0.001) and after HAART availability (MACS, adjusted-OR, 1.5; 95%CI 1.3-1.7; p<0.001; WIHS adjusted-OR, 2.2; 95%CI 1.8-2.7; p<0.001). Chronic obstructive pulmonary disease was more common in MACS HIV-infected vs. HIV-uninfected participants pre-HAART (hazard ratio [adjusted-HR] 2.9; 95%CI, 1.02-8.4; p = 0.046). After HAART availability, non-infectious lung diseases were not significantly more common in HIV-infected participants in either MACS or WIHS participants. HIV-infected participants in the HAART era with respiratory infections had an increased risk of death compared to those without infections (MACS adjusted-HR, 1.5; 95%CI, 1.3-1.7; p<0.001; WIHS adjusted-HR, 1.9; 95%CI, 1.5-2.4; p<0.001). CONCLUSION: HIV infection remained a significant risk for infectious respiratory diseases after the introduction of HAART, and infectious respiratory diseases were associated with an increased risk of mortality.
Source: PLoS ONE
Authors: Matthew R. Gingo, G. K. Balasubramani, Lawrence Kingsley, Charles R. Rinaldo, Christine B. Alden, Roger Detels, Ruth M. Greenblatt, Nancy A. Hessol, Susan Holman, Laurence Huang, Eric C. Kleerup, John Phair, Sarah H. Sutton, Eric C. Seaberg, Joseph B. Margolick, Stephen R. Wisniewski, Alison Morris
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,382
Funders: Northwestern University, Johns Hopkins University, University of Pittsburgh, Deutsches Krebsforschungszentrum, National Institutes of Health, University of California, San Francisco, Feinberg School of Medicine, Johns Hopkins Bloomberg School of Public Health, National Heart, Lung, and Blood Institute, National Institute of Mental Health, National Institute on Drug Abuse, National Cancer Institute, National Institute on Deafness and Other Communication Disorders, National Institute of Allergy and Infectious Diseases, National Institute of Child Health and Human Development, National Center for Research Resources, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: G1025189317, G1047576501, G1089263533, G1252706584, G1290148215, G1360453192, G1377681116, G1383752764, G141124744, G1423343497, G1440661678, G1540230653, G1648982045, Clinical and Translational Science Institute, G1653728403, G1689765846, G1705418768, G1732606383, G1826418709, G1919789535, G2037985070, G206316562, G2072110039, G2088232294, G216444255, G2210861095, G227110230, G2567544100, G2574405597, G2640595981, G2674972404, G2690160998, G2692709432, G27852282, G2794792237, G2889922178, G3009646583, G3013054560, G3079921036, G316338625, G3212103026, G3222910550, G3264576717, G3322721267, The Connie Wofsy Women's HIV Study, G3414024915, G3436481580, G344188330, G3443798915, G3481933404, Brooklyn Women's Interagency HIV Study (WIHS) V, G359857122, G3634354056, G3658850503, G3829424497, G3901006228, G398667773, G403271778, G4097647764, G4142465102, Natural History of AIDS in Homosexual Men, G4210511483, G4330383484, G4419450409, WIHS Data Management and Analysis Center (WDMAC), G4538066223, G4547062945, G4622231416, G4664570284, G4698605015, G4804712267, G4897434353, G498379488, G499585988, Chicago WIHS Consortium V (CWC), G508464731, G51363488, G5182092287, G5282551706, Center/Coordination, Analysis and Management/MACS, G536099884, G5514441876, Washington Women's Interagency HIV/AIDS Study, G555535742, G5577046437, G5771642997, G5909718580, G592158972, G604406090, G6295786800, G669420692, G6694807131, Multicenter AIDS Cohort Study, G714446084, G7195401492, G758528517, G769023845, G773494495, G7777414286, G8121648955, G814781356, G826976987, G8350406629, G8355300055, G893076474, G8937114048, G8962527242, G8964979204, Prevalence & Pathogenesis of Pulmonary Disease in a Large Multicenter HIV Cohort, G9000034972, G9000047430, G9000058261, G9000073987, G9000105478, G9000144501, G9000166853, G9000189465, G9000200690, G9000237332, G9000281659, G9000332745, G9000338758, Center for HIV Identification, Prevention and Treatment Services, G901243891, G901343485, G90347297, G920507375, G925273713, G937853209, G976727283, G986692823
OpenAlex ID: W2100575221