As new HIV therapies prolong the lives and improve the health of sufferers, patients have been urged to consider long-term health factors.

Patients with HIV are twice as likely to smoke and also more susceptible to the detrimental effects of smoking due to a swifter decline in lung function, new research shows.

"Early in the epidemic, HIV was a different disease - with few effective drugs, the best that an HIV-positive patient could hope for was a relatively painless death after a brief period," said Syed Kadri of Ohio State University medical centre.

"The long-term effects of HIV were therefore fairly obvious: death. But with the advent of a new class of anti-retroviral drugs called 'highly active anti-retroviral therapy,' or HAART, the clinical picture of HIV has changed. The disease has gone from being an automatic death sentence to a chronic condition, and like all chronic conditions, it brings with it other complications that can seriously affect the lives of those who have it."

Today's study evaluated declines in lung function among HIV-positive patients.

Patients involved in the study, mostly men in their 40s, half of whom were smokers, were assessed at baseline for two measures of respiratory status, FEV1 and DLCO, and had been followed for two years at the time of reporting. FEV1 is a measure of expiratory flow in one second, a standard gauge of lung capacity, whereas DLCO is a measurement of diffusing capacity of the lungs and is decreased in patients with emphysema.

At the end of two years, the 63 patients displayed marked declines in lung function, going from an average FEV1 of 88 per cent predicted to 83.2 per cent and a DLCO of 77.6 to 70.0.

"This is the type of decline you might expect to see in elderly individuals who have a long history of smoking," said Mr Kadri.

"These results indicate that HIV-positive patients are more susceptible to lung-related problems than HIV-negative individuals and that HIV-positive smokers are even more susceptible to developing early emphysema. We don't know when these differences begin to manifest in HIV-positive individuals who smoke, but the severity is likely a function of the time that they have lived with the disease."
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