Incidence of Chronic Obstructive Pulmonary Disease in People With Human Immunodeficiency Virus and Their Parents and Siblings in Denmark

• Published in: The Journal of infectious diseases Vol. 225; no. 3; pp. 492 - 501
• Main Authors: Ronit, Andreas, Omland, Lars H, Kronborg, Gitte, Pedersen, Gitte, Nielsen, Lars, Mohey, Rajesh, Wiese, Lothar, Obel, Niels, Ahlström, Magnus G
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 01.02.2022
• Subjects: CD4 antigen; Chronic obstructive pulmonary disease; Educational attainment; HIV; Human immunodeficiency virus; Immune system; Lung diseases; Lymphocytes T; Obstructive lung disease; Regression analysis; Risk factors; Siblings; Smoking; Viruses; epidemiology; HIV; socioeconomic status; smoking; COPD
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/jiab369

Abstract Background People with human immunodeficiency virus (PWH) may be at increased risk of several respiratory syndromes including chronic obstructive pulmonary disease (COPD). In matched cohort studies, we examined risk factors for COPD in PWH and their parents and siblings compared with population controls. Methods Using data from national registries, competing risk regression models were constructed and used to calculate adjusted hazard ratios (aHRs) for COPD. We evaluated the effect of human immunodeficiency virus characteristics, smoking, and educational attainment on COPD incidence in PWH. Results A total of 226 PWH and 1029 population controls were diagnosed with COPD during 63 661 and 562 171 person-years of follow-up. PWH had increased risk of being diagnosed with COPD compared to controls (aHR, 2.02 [95% confidence interval, 1.75–2.33]). Parents and siblings of PWH were also more likely to be diagnosed with COPD compared to controls. CD4+ T-cell counts were not associated with COPD, but unsuppressed viral replication, smoking status, and educational attainment were associated with COPD in PWH. No COPD diagnoses were registered in PWH with high educational attainment and absence of smoking Conclusions PWH have an increased risk of being diagnosed with COPD, as have their parents and siblings. This seems to be driven primarily by smoking and low socioeconomic status. Incidence of chronic obstructive pulmonary disease is higher in people with HIV and their parents and siblings than in population controls. The most important determinants explaining this seem to be cigarette smoking and low socioeconomic status.