HIV and COPD: impact of risk behaviors and diseases on quality of life
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- Drummond, M.B., Kirk, G.D., McCormack, M.C. et al. Qual Life Res (2010) 19: 1295. doi:10.1007/s11136-010-9701-x
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Smoking worsens quality of life among HIV-infected individuals, but it remains unclear if this association is related simply to smoking or to chronic obstructive pulmonary disease (COPD), the end-organ disease caused by smoking.
Using cross-sectional data from the AIDS Linked to the Intravenous Experience study, we determined the independent effects of smoking, HIV and COPD assessed using the Medical Outcome Studies-HIV questionnaire.
Of 973 participants, 287 (29.5%) were HIV infected and 151 (15.5%) had spirometry-defined obstruction. Eight hundred and thirty-four (85.7%) were current smokers with 23.3 mean pack-years history. HIV infection was independently associated with reduced physical and mental health. COPD was associated with a trend toward worse physical health (−1.48 units; 95%CI −3.33 to 0.38; p = 0.12) and was independently associated with worse mental health (−2.43 units; 95%CI −4.22 to −0.64; p < 0.01). After accounting for COPD and other covariates, smoking was not associated with changes in physical or mental health.
The presence of COPD, rather than smoking, is associated with worse quality of life independent of HIV infection. Diagnosis and management of COPD in former or current smokers with or at risk for HIV may further improve quality of life.
KeywordsQuality of life Chronic obstructive pulmonary disease Human immunodeficiency virus Injection drug use Smoking Tobacco use
AIDS Linked to the Intravenous Experience
Body mass index
CD4+ T-helper cells
Chronic obstructive pulmonary disease
Forced expiratory volume in 1 s
Forced vital capacity
Highly active antiretroviral therapy
Human immunodeficiency virus
Injection drug user
Medical outcomes studies-human immunodeficiency virus
Quality of life