scholarly journals DNA methylation is associated with airflow obstruction in patients living with HIV

Thorax ◽  
2020 ◽  
pp. thoraxjnl-2020-215866
Author(s):  
Ana I Hernandez Cordero ◽  
Chen Xi Yang ◽  
Maen Obeidat ◽  
Julia Yang ◽  
Julie MacIsaac ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Lung Function ◽  
Viral Infections ◽  
Airflow Obstruction ◽  
Normal Lung ◽  
People Living With Hiv ◽  
Global Methylation ◽  
Age Related ◽  
Impaired Lung Function ◽  
Living With Hiv

IntroductionPeople living with HIV (PLWH) suffer from age-related comorbidities such as COPD. The processes responsible for reduced lung function in PLWH are largely unknown. We performed an epigenome-wide association study to investigate whether blood DNA methylation is associated with impaired lung function in PLWH.MethodsUsing blood DNA methylation profiles from 161 PLWH, we tested the effect of methylation on FEV1, FEV1/FVC ratio and FEV1 decline over a median of 5 years. We evaluated the global methylation of PLWH with airflow obstruction by testing the differential methylation of transposable elements Alu and LINE-1, a well-described marker of epigenetic ageing.ResultsAirflow obstruction as defined by a FEV1/FVC<0.70 was associated with 1393 differentially methylated positions (DMPs), while 4676 were associated with airflow obstruction based on the FEV1/FVC<lower limit of normal. These DMPs were enriched for biological pathways associated with chronic viral infections. The airflow obstruction group was globally hypomethylated compared with those without airflow obstruction. 103 and 7112 DMPs were associated with FEV1 and FEV1/FVC, respectively. No positions were associated with FEV1 decline.ConclusionA large number of DMPs were associated with airflow obstruction and lung function in a unique cohort of PLWH. Airflow obstruction in even relatively young PLWH is associated with global hypomethylation, suggesting advanced epigenetic ageing compared with those with normal lung function. The disturbance of the epigenetic regulation of key genes not previously identified in non-HIV COPD cohorts could explain the unique risk of COPD in PLWH.

scholarly journals Predictors of impaired pulmonary function in people living with HIV in an urban African setting

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sarah E. Van Riel ◽  
Kerstin Klipstein-Grobusch ◽  
Roos E. Barth ◽  
Diederick E. Grobbee ◽  
Charles Feldman ◽  
...  
Keyword(s):  
Lung Function ◽  
Characteristic Curve ◽  
Cross Sectional Study ◽  
Forced Expiratory Volume ◽  
Normal Lung ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Increased Risk ◽  
Impaired Lung Function ◽  
History Of

Background: Studies have associated HIV with an increased risk of obstructive lung disease (OLD).Objectives: We aimed to identify the predictive factors for impaired lung function in an urban, African, HIV-positive population.Method: A cross-sectional study was performed in Johannesburg, South Africa, from July 2016 to November 2017. A questionnaire was administered and pre- and post-bronchodilator spirometry conducted. The predictors investigated included age, sex, antiretroviral treatment (ART) duration, body mass index, history of tuberculosis (TB) or pneumonia, occupational exposure, environmental exposure, smoking and symptoms of OLD (cough, wheeze, mucus and dyspnoea). Impaired lung function was defined as a forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) ratio of 0.70, or below the 20th percentile of normal.Results: The 98 ART-naïve participants (mean age = 34.0, standard deviation [s.d.] = 8.2), 85 participants on first-line ART (mean age = 36.9, s.d. = 6.6) and 189 participants on second-line ART (mean age = 43.5, s.d. = 7.9) were predominantly female (65.6%). Of the participants, 64 (17.2%) had impaired lung function and 308 had normal lung function. Linear regression identified age (β = –0.003, P 0.01), male sex (β = –0.016, P = 0.03) and history of TB or pneumonia (β = –0.024, P 0.01) as independent predictors of a lower FEV1/FVC ratio. Following logistic regression, only a history of TB or pneumonia (odds ratio = 2.58, 95% confidence interval = 1.47–4.52) was significantly related to impaired lung function (area under the receiver operating characteristic curve = 0.64).Conclusion: Our data show that a history of TB or pneumonia predicts impaired lung function. In order to improve timely access to spirometry, clinicians should be alert to the possibility of impaired lung function in people with a history of TB or pneumonia.

scholarly journals Stigma mastery in people living with HIV: gender similarities and theory

2021 ◽  
Author(s):  
Charles Patrick Namisi ◽  
John C. Munene ◽  
Rhoda K. Wanyenze ◽  
Anne R. Katahoire ◽  
Rosalinda M. Parkes-Ratanshi ◽  
...  
Keyword(s):  
Older Women ◽  
Social Exclusion ◽  
Theoretical Framework ◽  
People Living With Hiv ◽  
Negative Effects ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
Age Related ◽  
Related Stigma ◽  
Living With Hiv

Abstract Aims This study aimed to determine the prevalence of, factors associated with, and to build a theoretical framework for understanding Internalsed HIV-related Stigma Mastery (IHSM). Methods A cross-sectional study nested within a 2014 Stigma Reduction Cohort in Uganda was used. The PLHIV Stigma Index version 2008, was used to collect data from a random sample of 666 people living with HIV (PLHIV) stratified by gender and age. SPSS24 with Amos27 softwares were used to build a sequential-mediation model. Results The majority of participants were women (65%), aged ≥ 40 years (57%). Overall, IHSM was 45.5% among PLHIV, that increased with age. Specifically, higher IHSM correlated with men and older women “masculine identities” self-disclosure of HIV-diagnosis to family, sharing experiences with peers. However, lower IHSM correlated with feminine gender, the experience of social exclusion stress, fear of future rejection, and fear of social intimacy. Thus, IHSM social exclusion with its negative effects and age-related cognition are integrated into a multidimensional IHSM theoretical framework with a good model-to-data fit. Conclusion Internalised HIV-related Stigma Mastery is common among men and older women. Specificially, “masculine identities” self-disclose their own HIV-positive diagnosis to their family, share experiences with peers to create good relationships for actualising or empowerment in stigma mastery. However, social exclusion exacerbates series of negative effects that finally undermine stigma mastery by young feminine identities. Thus, stigma mastery is best explained by an integrated empowerment framework, that has implications for future practice, policy, and stigma-related research that we discuss.

scholarly journals Vaccine responses in ageing and chronic viral infection

2021 ◽  
Author(s):  
Chloe Rees-Spear ◽  
Laura E McCoy
Keyword(s):  
Viral Infections ◽  
The Elderly ◽  
People Living With Hiv ◽  
Chronic Infections ◽  
Vaccine Responses ◽  
Inflammatory Conditions ◽  
Immunological Changes ◽  
Cellular Responsiveness ◽  
Living With Hiv ◽  
The Impact

Abstract Lay Summary Improved life expectancy in recent years has led to a growing population of adults over the age of 60. Age is commonly associated with increased inflammatory conditions and infections. Similar immunological changes have been observed during chronic infections, in particular HIV, where this is compounded by the success of antiretroviral therapy that has increased the number of people living with HIV into their sixties and beyond. The increased susceptibility of these groups to infection makes vaccination all the more important. However, the alterations to their immune systems call into question how effective those vaccinations may be. Here we discuss vaccine efficacy within elderly and chronically infected populations and investigate the immunological changes that may impact vaccine responsiveness. Over the last few decades, changing population demographics have shown that there is a growing number of individuals living past the age of 60. With this expanding older population comes an increase in individuals that are more susceptible to chronic illness and disease. An important part of maintaining health in this population is through prophylactic vaccination, however, there is growing evidence that vaccines may be less effective in the elderly. Furthermore, with the success of anti-viral therapies, chronic infections such as HIV are becoming increasingly prevalent in older populations and present a relatively unstudied population with respect to the efficacy of vaccination. Here we will examine the evidence for age-associated reduction in antibody and cellular responsiveness to a variety of common vaccines, and investigate the underlying causes attributed to this phenomenon, such as inflammation and senescence. We will also discuss the impact of chronic viral infections on immune responses in both young and elderly patients, particularly those living with HIV, and how this affects vaccinations in these populations.

scholarly journals Prevalence and burden of chronic bronchitis symptoms: results from the BOLD study

2017 ◽  
Vol 50 (5) ◽  
pp. 1700621 ◽  
Author(s):  
Filip Mejza ◽  
Louisa Gnatiuc ◽  
A. Sonia Buist ◽  
William M. Vollmer ◽  
Bernd Lamprecht ◽  
...  
Keyword(s):  
Lung Function ◽  
Lung Disease ◽  
Chronic Bronchitis ◽  
Airflow Obstruction ◽  
Population Based ◽  
Normal Lung ◽  
Increased Risk ◽  
Potential Risk Factors ◽  
Definition Of ◽  
Disease Study

We studied the prevalence, burden and potential risk factors for chronic bronchitis symptoms in the Burden of Obstructive Lung Disease study.Representative population-based samples of adults aged ≥40 years were selected in participating sites. Participants completed questionnaires and spirometry. Chronic bronchitis symptoms were defined as chronic cough and phlegm on most days for ≥3 months each year for ≥2 years.Data from 24 855 subjects from 33 sites in 29 countries were analysed. There were significant differences in the prevalence of self-reported symptoms meeting our definition of chronic bronchitis across sites, from 10.8% in Lexington (KY, USA), to 0% in Ile-Ife (Nigeria) and Blantyre (Malawi). Older age, less education, current smoking, occupational exposure to fumes, self-reported diagnosis of asthma or lung cancer and family history of chronic lung disease were all associated with increased risk of chronic bronchitis. Chronic bronchitis symptoms were associated with worse lung function, more dyspnoea, increased risk of respiratory exacerbations and reduced quality of life, independent of the presence of other lung diseases.The prevalence of chronic bronchitis symptoms varied widely across the studied sites. Chronic bronchitis symptoms were associated with significant burden both in individuals with chronic airflow obstruction and those with normal lung function.

Airflow obstruction, impaired lung function and risk of sudden cardiac death: a prospective cohort study

Thorax ◽  
2021 ◽  
pp. thoraxjnl-2020-215632
Author(s):  
Yun-Jiu Cheng ◽  
Zhen-Guang Chen ◽  
Feng-Juan Yao ◽  
Li-Juan Liu ◽  
Ming Zhang ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Lung Function ◽  
Cardiac Death ◽  
Airflow Obstruction ◽  
Partial Likelihood ◽  
Race And Gender ◽  
Increased Risk ◽  
Impaired Lung Function ◽  
And Gender ◽  
Lung Health

BackgroundGrowing evidence suggests that compromised lung health may be linked to cardiovascular disease. However, little is known about its association with sudden cardiac death (SCD).ObjectivesWe aimed to assess the link between impaired lung function, airflow obstruction and risk of SCD by race and gender in four US communities.MethodsA total of 14 708 Atherosclerosis Risk in Communities (ARIC) study participants who underwent spirometry and were asked about lung health (1987–1989) were followed. The main outcome was physician-adjudicated SCD. Fine-Gray proportional subdistribution hazard models with Firth’s penalised partial likelihood correction were used to estimate the HRs.ResultsOver a median follow-up of 25.4 years, 706 (4.8%) subjects experienced SCD. The incidence of SCD was inversely associated with FEV1 in each of the four race and gender groups and across all smoking status categories. After adjusting for multiple measured confounders, HRs of SCD comparing the lowest with the highest quintile of FEV1 were 2.62 (95% CI 1.62 to 4.26) for white males, 1.80 (95% CI 1.03 to 3.15) for white females, 2.07 (95% CI 1.05 to 4.11) for black males and 2.62 (95% CI 1.21 to 5.65) for black females. The above associations were consistently observed among the never smokers. Moderate to very severe airflow obstruction was associated with increased risk of SCD. Addition of FEV1 significantly improved the predictive power for SCD.ConclusionsImpaired lung function and airflow obstruction were associated with increased risk of SCD in general population. Additional research to elucidate the underlying mechanisms is warranted.

Comorbid Medical Problems and Motivational Interviewing

2019 ◽  
pp. 97-104
Author(s):  
Sharon Connor ◽  
Hanna K. Welch
Keyword(s):  
Motivational Interviewing ◽  
Chronic Diseases ◽  
Congestive Heart Failure Patient ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Medical Problems ◽  
Patient Centered ◽  
Age Related ◽  
Social And Cultural Factors ◽  
Living With Hiv

As HIV treatments become more effective and accessible, people living with HIV (PLWH) are achieving longer lifespans; however, this aging population also faces a greater risk of age-related co-morbidities. Many chronic diseases affect people living with HIV disproportionately, including diabetes, ischemic heart disease, and congestive heart failure. Patient-centered healthcare should aim to optimize quality and length of life while also considering the person’s value system. Motivational interviewing (MI) has been effective in helping PLWH to better manage chronic diseases requiring behavioral modification in both high- and low-resource settings. MI is a useful approach in the complex care of PLWH and medical co-morbidities. MI can promote self-management integrating HIV care as well as other co-morbidities in the context of social and cultural factors. This chapter discusses the application of MI to achieve better control of co-morbid medical conditions in PLWH.

scholarly journals Rate of normal lung function decline in ageing adults: a systematic review of prospective cohort studies

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e028150 ◽  
Author(s):  
Elizabeth T Thomas ◽  
Michelle Guppy ◽  
Sharon E Straus ◽  
Katy J L Bell ◽  
Paul Glasziou
Keyword(s):  
Systematic Review ◽  
Lung Function ◽  
Cohort Studies ◽  
Lung Disease ◽  
Prospective Cohort ◽  
Normal Lung ◽  
Prospective Cohort Studies ◽  
Age Related ◽  
Disease Definition ◽  
Definition Of

ObjectiveTo conduct a systematic review investigating the normal age-related changes in lung function in adults without known lung disease.DesignSystematic review.Data sourcesMEDLINE, Embase and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched for eligible studies from inception to February 12, 2019, supplemented by manual searches of reference lists and clinical trial registries.Eligibility criteriaWe planned to include prospective cohort studies and randomised controlled trials (control arms) that measured changes in lung function over time in asymptomatic adults without known respiratory disease.Data extraction and synthesisTwo authors independently determined the eligibility of studies, extracted data and assessed the risk of bias of included studies using the modified Newcastle–Ottawa Scale.ResultsFrom 4385 records screened, we identified 16 cohort studies with 31 099 participants. All included studies demonstrated decline in lung function—forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and peak expiratory flow rate (PEFR) with age. In studies with longer follow-up (>10 years), rates of FEV1decline ranged from 17.7 to 46.4 mL/year (median 22.4 mL/year). Overall, men had faster absolute rates of decline (median 43.5 mL/year) compared with women (median 30.5 mL/year). Differences in relative FEV1change, however, were not observed between men and women. FEV1/FVC change was reported in only one study, declining by 0.29% per year. An age-specific analysis suggested the rate of FEV1function decline may accelerate with each decade of age.ConclusionsLung function—FEV1, FVC and PEFR—decline with age in individuals without known lung disease. The definition of chronic airway disease may need to be reconsidered to allow for normal ageing and ensure that people likely to benefit from interventions are identified rather than healthy people who may be harmed by potential overdiagnosis and overtreatment. The first step would be to apply age, sex and ethnicity-adjusted FEV1/FVC thresholds to the disease definition of chronic obstructive pulmonary disease.PROSPERO registration numberCRD42018087066.

scholarly journals Kidney Disease in HIV Infection

2019 ◽  
Vol 8 (8) ◽  
pp. 1254 ◽  
Author(s):  
Gaetano Alfano ◽  
Gianni Cappelli ◽  
Francesco Fontana ◽  
Luca Di Lullo ◽  
Biagio Di Iorio ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Life Expectancy ◽  
Early Recognition ◽  
Renal Involvement ◽  
People Living With Hiv ◽  
Risk Of Death ◽  
Age Related ◽  
Stage Renal Disease ◽  
End Stage ◽  
Living With Hiv

Antiretroviral therapy (ART) has significantly improved life expectancy of infected subjects, generating a new epidemiological setting of people aging withHuman Immunodeficiency Virus (HIV). People living with HIV (PLWH), having longer life expectancy, now face several age-related conditions as well as side effects of long-term exposure of ART. Chronic kidney disease (CKD) is a common comorbidity in this population. CKD is a relentlessly progressive disease that may evolve toward end-stage renal disease (ESRD) and significantly affect quality of life and risk of death. Herein, we review current understanding of renal involvement in PLWH, mechanisms and risk factors for CKD as well as strategies for early recognition of renal dysfunction and best care of CKD.

scholarly journals Insights to correlations and discrepancies between impaired lung function and heart failure in Eisenmenger patients

2020 ◽  
Vol 10 (1) ◽  
pp. 135065012090972 ◽  
Author(s):  
Lina Gumbiene ◽  
Lina Kapleriene ◽  
Dovile Jancauskaite ◽  
Monika Laukyte-Sleniene ◽  
Elena Jureviciene ◽  
...  
Keyword(s):  
Lung Function ◽  
Airway Obstruction ◽  
Natriuretic Peptide ◽  
Congenital Heart Defect ◽  
Congenital Heart ◽  
Airflow Obstruction ◽  
Gas Diffusion ◽  
Eisenmenger Syndrome ◽  
Heart Defect ◽  
Impaired Lung Function

Impaired lung function and spirometric signs of airway obstruction without common risk factors for chronic obstructive pulmonary disease could be found in patients with Eisenmenger syndrome. This study aimed to analyse the association between lung function parameters and disease severity (including heart failure markers, associated congenital heart defect) as well as the possible reasons for airflow obstruction in Eisenmenger syndrome. The data of 25 patients with Eisenmenger syndrome were retrospectively evaluated. The patients were divided into groups according to airflow obstruction and a type of congenital heart defect. Airflow obstruction was found in nearly third (32%) of our cases and was associated with older age and worse survival. No relation was found between airway obstruction, B-type natriuretic peptide level, complexity of congenital heart defect and bronchial compression. Most of the patients (88%) had gas diffusion abnormalities. A weak negative correlation was noticed between gas diffusion (diffusing capacity of the lung for carbon monoxide) and B-type natriuretic peptide level (r = −0.437, p = 0.033). Increased residual volume was associated with higher mortality (p = 0.047 and p = 0.021, respectively). A link between B-type natriuretic peptide and lung diffusion, but not airway obstruction, was found. Further research and larger multicentre studies are needed to evaluate the importance of pulmonary function parameters and mechanisms of airflow obstruction in Eisenmenger syndrome.

scholarly journals Carpal tunnel syndrome in HIV-positive patients coinfected with HCV

Reumatismo ◽  
2017 ◽  
Vol 69 (4) ◽  
pp. 164
Author(s):  
A. Mastroianni ◽  
F. Allegrini ◽  
S. Nardi ◽  
D. Donatucci ◽  
F. Girelli ◽  
...  
Keyword(s):  
General Population ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Hiv Disease ◽  
Age Related ◽  
Rheumatic Manifestations ◽  
Wide Range ◽  
Inflammatory State ◽  
Advanced Hiv Disease ◽  
Living With Hiv

A wide range of rheumatic and peripheral nervous system disorders may develop in patients with HIV infection, leading to pain, sensory symptoms, and muscle weakness. Over the past three decades, the progress in management of HIV disease with anti-retroviral therapy (ART) has resulted in increased life expectancy for people living with HIV disease. With this new chronicity of the disease has a constellation of chronic musculoskeletal, orthopaedic and rheumatic manifestations has emerged, as potential complications of the disease itself and/or the results of ART treatment regimen and/or because of expected age-related symptoms/manifestations. The incidence of CTS in the general population is around 3.8% with clinical examination and, when electroneuromyography is used, it is 2.7%. In the HIV-positive population, the incidence is very close to that of the general population. The aim of this study was to evaluate the incidence of CTS and to identify factors influencing the development of CTS in HIV-infected patients attending our clinic. This syndrome has been associated with advanced HIV disease and the use of ART possibly due to an increased inflammatory state and the presence of concurrent HCV infection.

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