Les maladies pulmonaires chroniques chez les patients vivant avec le VIH: les mécanismes responsables et les cibles potentielles d'intervention

 

Cecilia Costiniuk

Centre universitaire de santé McGill [CUSM]

 

Domaine : maladies infectieuses et immunitaires

Programme chercheurs-boursiers-cliniciens - Junior 1

Concours 2017-2018

Despite the success of antiretroviral therapy, people living with HIV (PLWH) have higher rates of respiratory symptoms and chronic lung disease than people without HIV.  Chronic obstructive pulmonary disease (COPD) is an inflammatory condition where there is difficulty breathing out air, and exhalation may not be completed prior to the next breath. PLWH have almost 4x times higher marijuana smoking rates than people without HIV. However, it is unknown if marijuana smoking is associated with respiratory symptoms, COPD or dysfunction of the small airways in PLWH.  Other factors, such as inflammation related to HIV itself, may also be associated with chronic lung disease although this has never been previously studied.

The first project in this research program involves collecting information on marijuana smoking and other risk factors for lung disease, such as tobacco smoking, workplace and environmental exposures.  Individuals will undergo screening using various tests (diffusing capacity for carbon monoxide, pulmonary function tests, oscillometry) in order to determine if marijuana smoking is associated with airflow obstruction or abnormalities of the small airways in the lungs. In the second project, HIV-infected volunteers with and without COPD will undergo a "bronchoscopy" (a procedure where a telescope is put down the throat for the doctor to examine the lungs).

This will enable us to collect fluid and cells from the lungs in order to measure the amount of HIV and inflammation within the lungs compared to the blood. We will determine whether there is an association between the amounts of HIV and inflammation within the lungs and airflow obstruction, as measured on spirometry. These findings will increase our understanding of risk factors for chronic lung disease in PLWH and will guide future research and patient care plans.