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research
The Impact of HAART on the Respiratory Complications of HIV Infection: Longitudinal Trends in the MACS and WIHS Cohorts
Authors
A Johannessen
A Lindberg
+62 more
AK Chaturvedi
Alison Morris
AN Phillips
B Balbi
BR Celli
Charles R. Rinaldo
Christine B. Alden
DB Coultas
E Gouws
EA Engels
EC Seaberg
Eric C. Kleerup
Eric C. Seaberg
F Gutin
FJ Palella Jr
FN Engsig
G. K. Balasubramani
GA D’Jaen
GD Kirk
GM Allardice
GM Clifford
J Almirall
Jason F. Okulicz
JE Kaplan
JF Murray
JM Wallace
John Phair
Joseph B. Margolick
JR Grubb
K Crothers
K Crothers
K Crothers
K Sigel
L Dal Maso
Laurence Huang
Lawrence Kingsley
M Bower
M Frisch
M Herida
Matthew R. Gingo
MR Gingo
MR Gingo
MS Shiels
NA Hessol
Nancy A. Hessol
O Sitbon
PY Hsue
R McKenzie
RA Kaslow
RD Moore
RE Hirschtick
RM Phelps
Roger Detels
Ruth M. Greenblatt
S Hariri
Sarah H. Sutton
SB Foster
SE Barkan
Stephen R. Wisniewski
Susan Holman
T Takahashi
V Dufour
Publication date
1 January 2013
Publisher
'Public Library of Science (PLoS)'
Doi
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on
PubMed
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. © 2013 Gingo et al
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