Lung and Heart Diseases Are Better Predicted by Pack-Years than by Smoking Status or Duration of Smoking Cessation in HIV Patients

Guaraldi, Giovanni; Raggi, Paolo; Gomes, André; Zona, Stefano; Marchi, Enrico; Santoro, Antonella; Besutti, Giulia; Scaglioni, Riccardo; Ligabue, Guido; Leipsic, Jonathon; Man, Paul; Sin, Don D.

doi:10.1371/journal.pone.0143700

Cited by 11 publications

(4 citation statements)

References 21 publications

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“…However, these studies relied on diagnostic codes without spirometry evidence and lacked information on confounders associated with lung function decline, or were not able to adjust for cumulative smoking,25 which may be a better predictor of COPD than smoking categorisation 27. Spirometric studies may draw a more precise estimate of COPD and be more suitable for evaluating the pulmonary effects of HIV.…”

Section: Discussionmentioning

confidence: 99%

Airflow limitation in people living with HIV and matched uninfected controls

Ronit

Lundgren

Afzal

et al. 2018

Thorax

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Section: Discussionmentioning

confidence: 99%

Airflow limitation in people living with HIV and matched uninfected controls

Ronit

Lundgren

Afzal

et al. 2018

Thorax

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“…Cancer types were categorised as tobacco-related cancers (cancers of the oral cavity, pharynx, larynx, oesophagus, stomach, colon and rectum, liver, pancreas, lung, kidney, bladder and cervix) 28 and other cancers. Cigarette pack-year, a measure of lifetime cigarette smoking predictive of lung function decline, 29 was calculated by multiplying the number of packs of cigarettes smoked per day by the total number of years the patient had smoked and categorised into quartiles (range 0.1–222.8, mean 32.3 (SD=27.2)). Duration of smoking cessation, a predictor associated with improved lung function and reduced risk of airway obstruction, 30 31 was calculated for former cigarette smokers based on their age at the time of data collection and the age and calendar month/year when they stopped smoking.…”

Section: Methodsmentioning

confidence: 99%

Association between heated tobacco product use and airway obstruction: a single-centre observational study, Japan

Odani,

Koyama,

Miyashiro

et al. 2024

BMJ Open Resp Res

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BackgroundWhile heated tobacco products (HTPs) may affect pulmonary function, the evidence supporting the utility of screening for HTP use in clinical settings is insufficient. We examined the association between HTP use and airway obstruction after switching from cigarettes.MethodThe study subjects were patients aged ≥20 years undergoing surgery from December 2021 to September 2022 who completed spirometry and reported tobacco (cigarette and HTP) use status during the preoperative assessment. Airway obstruction was defined as forced expiratory volume in 1 s to forced vital capacity ratio below the lower limit of normal. Current tobacco use was defined as past-30-day use. Multivariable Poisson regression analysis was performed to examine the associations between HTP use and airway obstruction by adjusting for demographic characteristics, lifetime cigarette smoking (pack-year) and duration of smoking cessation.ResultsOverall (N=2850, 55.4% women, mean age 62.4), 4.6% and 10.7% reported current HTP use and cigarette smoking, respectively. 16.8% had airway obstruction. Airway obstruction was more common among current HTP-only users (adjusted prevalence ratio (APR)=2.32), current cigarette-only smokers (APR=2.57) and current dual users (APR=2.82) than never-tobacco users. Among current tobacco users (N=398), the prevalence of airway obstruction was not significantly different between HTP-only users and cigarette-only smokers. Among former cigarette smokers (>30-day cigarette quitters) (N=1077), current HTP users had 1.42 times the increased prevalence of airway obstruction than never-HTP users after adjusting for cigarette pack-year; a stronger association was observed when the analysis was restricted to ≥5-year cigarette quitters (N=772) (APR=1.96, vs never HTP users).ConclusionCurrent HTP use was associated with airway obstruction among patients with cancer who had completely switched from cigarettes even after quitting smoking for a long period. Patients should be routinely screened for HTP use and advised to quit any tobacco.

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“…For both cases and controls, compliance with the exclusion criterion of being a current or former smoker was established through a detailed standardized questionnaire excluding the use of cigarettes, pipes, marijuana, cigarillos or electronic cigarettes . No urinary cotinine test was performed.…”

Section: Methodsmentioning

confidence: 99%

Significant chronic airway abnormalities in never‐smoking HIV‐infected patients

et al. 2019

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Objectives The aim of the study was to describe chronic lung disease in HIV‐infected never‐smokers by looking at clinical, structural and functional abnormalities. Methods This comparative cross‐sectional study included 159 HIV‐infected never‐smoking patients [mean (± standard deviation) age 54.6 ± 9.1 years; 13.2% female; 98.1% with undetectable viral load] and 75 nonmatched never‐smoking controls [mean (± standard deviation) age 52.6 ± 6.9 years; 46.7% female]. We examined calcium scoring computer tomography (CT) scans or chest CT scans, all with a lung‐dedicated algorithm reconstruction, to assess emphysema and airway disease (respiratory bronchiolitis and/or bronchial wall thickening), tested pulmonary function using spirometry, lung volumes and the diffusion lung capacity of carbon monoxide (DLCO), and assessed respiratory symptoms using the Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT). Results Twenty‐five (17.2%) of the HIV‐infected patients versus two (2.7%) of the controls had a CAT score > 10. Only 5% of the HIV‐infected patients showed FEV1% < 80%, and 25% had DLCO < 75% of the predicted value. Based on the CT scans, they had increased prevalences, compared with the controls, of airway disease (37% versus 7.9%, respectively) and emphysema (18% versus 4%, respectively), with more severe and more frequent centrilobular disease. After correction for age, sex and clinical factors, HIV infection was significantly associated with CAT > 10 [odds ratio (OR) 7.7], emphysema (OR 4), airway disease (OR 4.5) and DLCO < 75% of predicted (OR 4). Conclusions Although comparisons were limited by the different enrolment methods used for HIV‐infected patients and controls, the results suggest that never‐smoking HIV‐infected patients may present with chronic lung damage characterized by CT evidence of airway disease. A minority of them showed respiratory symptoms, without significant functional abnormalities.

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Lung and Heart Diseases Are Better Predicted by Pack-Years than by Smoking Status or Duration of Smoking Cessation in HIV Patients

Cited by 11 publications

References 21 publications

Airflow limitation in people living with HIV and matched uninfected controls

Airflow limitation in people living with HIV and matched uninfected controls

Association between heated tobacco product use and airway obstruction: a single-centre observational study, Japan

Significant chronic airway abnormalities in never‐smoking HIV‐infected patients

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