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HIV and COPD: impact of risk behaviors and diseases on quality of life

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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Abbreviations

ALIVE:

AIDS Linked to the Intravenous Experience

BMI:

Body mass index

CD4:

CD4+ T-helper cells

CI:

confidence interval

COPD:

Chronic obstructive pulmonary disease

FEV1:

Forced expiratory volume in 1 s

FVC:

Forced vital capacity

HAART:

Highly active antiretroviral therapy

HIV:

Human immunodeficiency virus

IDU:

Injection drug user

IQR:

Interquartile range

MOS-HIV:

Medical outcomes studies-human immunodeficiency virus

QOL:

Quality of life

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Financial support

This study was funded in part by grants from the NIH (RO1s HL090483, DA04334 and DA12568). MBD is supported by an Institute for Clinical and Translational Research (KL2) Mentored Career Development Award from the National Institutes of Health.

Conflicts of interest statement

None of the authors of this manuscript have any conflict of interest or financial disclosures related to this manuscript.

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Authors and Affiliations

  1. Department of Medicine, School of Medicine, Johns Hopkins University, 5501 Hopkins Bayview Circle, JHAAC 4B.70, Baltimore, MD, 21224, USA

    M. Bradley Drummond, Gregory D. Kirk, Meredith C. McCormack, Robert A. Wise & Christian A. Merlo

  2. Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA

    Gregory D. Kirk, Mariah M. Marshall, Erin P. Ricketts & Shruti H. Mehta

Authors
  1. M. Bradley Drummond
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  2. Gregory D. Kirk
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  3. Meredith C. McCormack
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  6. Shruti H. Mehta
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Correspondence to M. Bradley Drummond.

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Drummond, M.B., Kirk, G.D., McCormack, M.C. et al. HIV and COPD: impact of risk behaviors and diseases on quality of life. Qual Life Res 19, 1295–1302 (2010). https://doi.org/10.1007/s11136-010-9701-x

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