HIV INFECTION LINKED TO CHRONIC LUNG DISEASENew research shows that patients who are HIV positive may be at an increased risk for developing chronic obstructive pulmonary disease (COPD). Researchers from Yale University School of Medicine investigated the prevalence of COPD among 1,014 HIV-positive and 713 HIV-negative men enrolled in the Veterans Aging Cohort 5 Site Study. Results showed that the prevalence of COPD was 10 percent in HIV-positive and 9 percent in HIV-negative patients, as reported by ICD-9 codes, and 15 percent and 12 percent respectively, as indicated by patient self-report. However, after adjusting for age, race/ethnicity, pack-years of smoking, and injection drug use and alcohol abuse, HIV infection was an independent risk factor for COPD, with HIV-infected patients 50 to 60 percent more likely to have COPD than HIV-negative subjects. This study appears in the November issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.
VITAMIN A EVALUATED AS POTENTIAL TREATMENT FOR EMPHYSEMARetinoids, derivatives of vitamin A, are being examined as a potential method for regenerating damaged lung tissue in patients with emphysema. In the "Feasibility of Retinoids for the Treatment of Emphysema" (FORTE) study, researchers from six institutions in the United States enrolled 148 subjects with moderate-to-severe chronic obstructive pulmonary disease (COPD) with a primary component of emphysema. Patients received all-trans retinoic acid (ATRA) at either a low or high dose, 13-cis retinoic acid (13-cRA), or placebo for 6 months followed by a 3-month crossover period. At the end of 6 months, no treatment was associated with an overall improvement in pulmonary function, CT density mask score, or health-related quality of life (HRQL). However, time- and dose-dependent changes in diffusing capacity, CT density mask score, and HRQL were observed in patients that achieved the highest blood levels of ATRA. These preliminary results do not support the clinical use of retinoids at this time, but warrant further development and investigation of this new approach. This study appears in the November issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.
PERCEIVED CONTROL IMPROVES ASTHMA HEALTH STATUSPatients with asthma who believe they have control of their condition are likely to report improved asthma-related health status and have a decreased risk of severe asthma attacks. In a new study out of the University of California, San Francisco, researchers followed 865 patients (mean age 60 years) hospitalized for asthma for a median of 1.9 years after hospital discharge. Researchers collected demographic information, asthma history, perceived asthma control, and measured emergency department (ED) visits and hospitalizations for asthma. Results indicated that greater perceived control was associated with better physical health status, better asthma-related quality of life, fewer days of restricted activity due to asthma, and lower asthma severity scores. A multivariate model also showed that greater perceived control was associated with significantly decreased prospective risk of ED visits and hospitalizations for asthma. This study appears in the November issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.