Grant: Operating Grant - PA: HIV/AIDS - Comorbidity - Biomedical/Clinical Research

Chronic obstructive lung disease affects ~10% of adult Canadians and is the 4th leading cause of death, and the 3rd leading cost of health care expenses. In susceptible individuals, premature aging of the lung can be triggered by exposure of noxious materials, such as cigarette smoking, environmental pollution, and infection. Surprisingly, this condition will continue to progress even after the noxious exposure has ceased years ago. The widespread use of highly effective treatment for HIV infection has improved the survival of these patients from 10-2 to 1-3 per 100 person years. These individuals are dying frequently of coronary artery disease, malignancies, and emphysema, but two decades earlier than in the general population. A disease such as emphysema that takes decades to evolve gives physicians time to intervene, but it also makes it difficult to decide what we do has made a difference until years/decades later. For a variety of reasons, HIV infection has put emphysema on a fast track, allowing the disease and its complications to develop in years instead of decades. There are several benefits of the proposed study to Canadians. By finding out the reason why emphysema is so common and why it occurs at a younger in HIV patients will enable the health care professionals and officials come up with a better strategy to manage the problem with public health measures, pharmacological and non-pharmacological treatment. Because of the aggressive nature of the condition, we will be able find out if the treatment would work over a shorter time course (months or years instead of decades). We will also gain important insight into the aging process, such as how a viral infection and emphysema may contribute to premature aging, and vice versa. Finally, this study may identify individuals who are at risk of developing emphysema with simple blood tests and lung function, so that a concerted effort can be directed to those who will be most likely in need of help.