People With HIV at Increased Risk of Debilitating Lung Disease

October 7, 2015

People With HIV at Increased Risk of Debilitating Lung Disease

Trailing only behind heart disease and stroke, chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the world and in the U.S. Yet public awareness about this debilitating lung disease is low. Many people either have never heard of it, aren't aware of how to prevent it, or don't know how severe its symptoms can be. It's a growing concern especially for people aging with HIV -- who appear to be more likely to get COPD and may experience a faster decline if they do get it.

"In the early days of the AIDS epidemic, the lung was clearly a focus and a leading area of research because patients were presenting with things like Pneumocystis pneumonia," said Ken Kunisaki, M.D., a pulmonary disease specialist at the Minneapolis Veterans Affairs Health Care System. "With better HIV treatments, we don't see much of that anymore. But now as patients are aging, two big concerns are COPD and lung cancer. In the long-term, being aware of the non-infectious lung complications of HIV -- like COPD and lung cancer -- will enable us to help people with HIV age successfully."

COPD is a catch-all name for progressive lung disease -- encompassing conditions like emphysema and chronic bronchitis -- that prevents a person from breathing and exhaling air normally from the lungs. People with COPD experience symptoms like shortness of breath, wheezing, chronic coughing and fatigue.

Jan Karlbon (Credit: American Lung Association of Arizona)

Jan Karlbon (Credit: American Lung Association of Arizona)

"It's like somebody put duct tape over your mouth and your nose, and someone cut a little hole, and you're breathing through a straw," said Jan Karlbon, in a video created by the American Lung Association of Arizona. "Something as simple as getting dressed can wear me out. There's some nights when I can cook a meal, there are times that I can't. Something as easy as boiling a pot of water to make spaghetti -- by the time I get the water from the sink to the stove -- can have me short of breath."

In the general population, the prevalence is 6.3%, with 12.7 million people diagnosed with COPD and almost twice that (24.1 million) estimated to have impaired lung function. A few studies that have compared people living with HIV to HIV-negative people have found that the rates of COPD are higher among people with HIV.

The majority of this risk probably comes from cigarette smoking -- the leading cause of COPD -- since a higher percentage of people with HIV smoke compared to the general population. But Kunisaki says the difference extends beyond behavior.

"When studies control for history of smoking, it does look like patients with HIV are at a higher risk of developing COPD," he explained.

This excerpt was cross-posted with the permission of Read the full article.

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