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Ann Intern Med. 2000 Mar 7;132(5):369-72.

Increased susceptibility to pulmonary emphysema among HIV-seropositive smokers.

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Department of Internal Medicine, Ohio State University, Columbus 43210, USA.



Previous uncontrolled reports have suggested that HIV-seropositive persons develop an accelerated form of emphysema.


To characterize the risk for emphysema in a stable HIV-seropositive outpatient population.


Controlled, cross-sectional analysis.


Midwestern urban community.


HIV-seropositive persons (n = 114) without AIDS-related pulmonary complications and HIV-seronegative controls (n = 44), matched for age and smoking history.


Measurement of pulmonary function, bronchoalveolar lavage, and high-resolution computed tomography of the chest.


The incidence of emphysema was 15% (17 of 114) in the HIV-seropositive group compared with 2% (1 of 44) in the HIV-seronegative group (P = 0.025). The incidence of emphysema in participants with a smoking history of 12 pack-years or greater was 37% (14 of 38 persons) in the HIV-seropositive group compared with 0% (0 of 14 persons) in the HIV-seronegative group (P = 0.011). The percentage of cytotoxic lymphocytes in lavage fluid was much higher in HIV-seropositive smokers with emphysema.


Infection with HIV accelerates the onset of smoking-induced emphysema. The results of this study support the emerging concept that cytotoxic lymphocytes may have an important role in emphysema pathogenesis.

[Indexed for MEDLINE]

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