Introduction Chronic lung disease is common among people living with HIV (PLWH). We hypothesised that PLWH receiving antiretroviral therapy (ART) have faster lung function decline than matched controls. Methods We performed a prospective matched cohort study by including ART-treated PLWH from the Copenhagen Co-morbidity in HIV Infection Study (n=705) and the INSIGHT Strategic Timing of Antiretroviral Treatment Pulmonary Substudy (n=425) and frequency matched population controls from the Copenhagen General Population Study (n=2895) in a 1:3 ratio. Eligible participants were ≥25 years old and had two spirometry tests separated by at least 2 years of follow-up. Forced expiratory volume in 1 s (FEV1) decline (mL/year) was compared between PLWH and controls using a linear mixed model adjusted for age, sex, ethnicity and smoking status. Effect modification by smoking was investigated in subgroup analyses. Results The majority of PLWH were virally suppressed (96.1%). The adjusted mean annual decline in FEV1 was faster in PLWH than in controls with 36.4 (95% CI 33.7 to 39.1) vs 27.9 (95% CI 26.9 to 28.8) mL/year, yielding a difference of 8.5 (95% CI 5.6 to 11.4) mL/year. The association between HIV and FEV1 decline was modified by smoking, with the largest difference in current smokers (difference: 16.8 (95% CI 10.5 to 23.0) mL/year) and the smallest difference in never-smokers (difference: 5.0 (95% CI 0.7 to 9.3) mL/year). FEV1 decline >40 mL/year was more prevalent in PLWH (adjusted OR: 1.98 (95% CI 1.67 to 2.34)). Conclusion Well-treated PLWH have faster lung function decline than controls and smoking seems to modify this association, suggesting that smoking may lead to more rapid lung function decline in PLWH than in controls. Due to restrictions from the Danish Data Protection agency no data are available.

中文翻译：

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尽管进行了充分治疗，艾滋病毒感染者的肺功能仍会更快下降：一项纵向匹配队列研究


简介 慢性肺病在艾滋病毒感染者 (PLWH) 中很常见。我们假设接受抗逆转录病毒治疗（ART）的感染者比匹配的对照组肺功能下降得更快。方法 我们进行了一项前瞻性匹配队列研究，纳入了来自哥本哈根艾滋病毒感染共病研究 (n=705) 和 INSIGHT 抗逆转录病毒治疗肺部亚研究战略时机 (n=425) 的接受 ART 治疗的 PLWH，以及频率匹配的人群对照哥本哈根一般人口研究 (n=2895)，比例为 1:3。符合资格的参与者年龄≥25 岁，并进行了两次肺活量测定测试，且随访时间至少间隔 2 年。使用针对年龄、性别、种族和吸烟状况进行调整的线性混合模型，对 PLWH 和对照组之间的 1 秒用力呼气量 (FEV1) 下降（毫升/年）进行比较。在亚组分析中研究了吸烟对效应的影响。结果 大多数感染者病毒得到抑制（96.1%）。调整后的 FEV1 平均年下降速度在感染者中比对照组更快，分别为 36.4（95% CI 33.7 至 39.1）vs 27.9（95% CI 26.9 至 28.8）mL/年，差异为 8.5（95% CI 5.6 至 11.4） ) 毫升/年。 HIV 和 FEV1 下降之间的关联因吸烟而改变，目前吸烟者的差异最大（差异：16.8（95% CI 10.5 至 23.0）mL/年），从不吸烟者的差异最小（差异：5.0（95% CI） CI 0.7 至 9.3）毫升/年）。 FEV1 下降 >40 mL/年在 PLWH 中更为普遍（调整后 OR：1.98（95% CI 1.67 至 2.34））。结论 治疗良好的 PLWH 的肺功能下降速度比对照组更快，而吸烟似乎改变了这种关联，表明吸烟可能导致 PLWH 的肺功能下降速度比对照组更快。 由于丹麦数据保护机构的限制，没有可用的数据。