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The Impact of HAART on the Respiratory Complications of HIV Infection: Longitudinal Trends in the MACS and WIHS Cohorts

Gingo, MR and Balasubramani, GK and Kingsley, L and Rinaldo, CR and Alden, CB and Detels, R and Greenblatt, RM and Hessol, NA and Holman, S and Huang, L and Kleerup, EC and Phair, J and Sutton, SH and Seaberg, EC and Margolick, JB and Wisniewski, SR and Morris, A (2013) The Impact of HAART on the Respiratory Complications of HIV Infection: Longitudinal Trends in the MACS and WIHS Cohorts. PLoS ONE, 8 (3).

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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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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Gingo, MRmrg35@pitt.eduMRG35
Balasubramani, GKBalaGK@edc.pitt.eduBKG100000-0001-7221-1825
Kingsley, Lkingsley@pitt.eduKINGSLEY
Rinaldo, CR
Alden, CB
Detels, R
Greenblatt, RM
Hessol, NA
Holman, S
Huang, L
Kleerup, EC
Phair, J
Sutton, SH
Seaberg, EC
Margolick, JB
Wisniewski, SRwisniew@edc.pitt.eduSTEVEWIS
Morris, A
Date: 12 March 2013
Date Type: Publication
Journal or Publication Title: PLoS ONE
Volume: 8
Number: 3
DOI or Unique Handle: 10.1371/journal.pone.0058812
Schools and Programs: Graduate School of Public Health > Epidemiology
Graduate School of Public Health > Infectious Diseases and Microbiology
School of Medicine > Immunology
School of Medicine > Medicine
School of Medicine > Pathology
Refereed: Yes
Date Deposited: 08 Apr 2013 17:14
Last Modified: 05 Feb 2019 02:55
URI: http://d-scholarship.pitt.edu/id/eprint/17877

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