Ambient particulate matter, a novel factor hindering life spans of HIV/AIDS patients: Evidence from a ten-year cohort study in Hubei, China

Faxue Zhang; Shijie Zhu; Hen Tang; Dingyuan Zhao; Xupeng Zhang; Gaichan Zhao; Xiaowei Zhang; Tianzhou Li; Lianguo Ruan; Wei Zhu

doi:10.1016/j.scitotenv.2023.162589

Ambient particulate matter, a novel factor hindering life spans of HIV/AIDS patients: Evidence from a ten-year cohort study in Hubei, China

Sci Total Environ. 2023 Jun 1:875:162589. doi: 10.1016/j.scitotenv.2023.162589. Epub 2023 Mar 3.

Authors

Faxue Zhang¹, Shijie Zhu¹, Hen Tang², Dingyuan Zhao², Xupeng Zhang³, Gaichan Zhao³, Xiaowei Zhang¹, Tianzhou Li¹, Lianguo Ruan⁴, Wei Zhu⁵

Affiliations

¹ Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China.
² Institute of Chronic Infectious Disease Prevention and Control, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China.
³ Department of Public Health, School of Public Health, Wuhan University, Wuhan 430071, China.
⁴ Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology; Hubei Clinical Research Center for Infectious Diseases; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences; Joint Laboratory of Infectious Diseases and Health, Wuhan Institute of Virology and Wuhan Jinyintan Hospital, Chinese Academy of Sciences, Wuhan, 430023, China. Electronic address: ruanlianguo_whjyt@163.com.
⁵ Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China. Electronic address: weizhu@whu.edu.cn.

PMID: 36871737
DOI: 10.1016/j.scitotenv.2023.162589

Abstract

Background: The life spans of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients have been extended in the era of antiretroviral therapy. However, few studies have considered the influence of the environment on the life expectancy of people living with HIV/AIDS. Several studies have investigated mortality and air pollution associations, but the evidence for associations between long-term exposure to particulate matter (PM) and mortality among HIV/AIDS patients remains extremely sparse.

Methods: We conceived a dynamic cohort study by enrolling people with HIV/AIDS from 103 counties in Hubei province, China from 2010 to 2019, with 23,809 persons and 78,457.2 person-years of follow-up. The county-level annual concentrations of PM_2.5 and PM₁₀ were extracted from the ChinaHighAirPollutants dataset. Cox proportional hazards models with time-varying exposures were conducted to assess the associations between PM and mortality.

Results: Per 1 μg/m³ increased in PM_2.5 and PM₁₀ would elevate 0.69 % (95 % CIs: 0.39, 1.00) and 0.39 % (95 % CIs: 0.18, 0.59) risk of all-cause deaths (ACD) and 1.65 % (95 % CIs: 1.14, 2.17) and 0.90 % (95 % CIs: 0.56, 1.24) of AIDS-related deaths (ARD), respectively. Significantly stronger associations of PM-ARD were found in patients aged over 60 years old, with corresponding excess risk of 2.66 % (95 % CIs: 1.76, 3.58) for PM_2.5 and 1.62 (95 % CIs: 1.01, 2.23) for PM₁₀.

Conclusions: This study added to the existing evidence that long-term exposure to ambient PM adversely affects the life spans of HIV/AIDS patients. Hence, public health departments should take proactive measures to prevent further life loss and promote survival among those living with HIV/AIDS.

Keywords: AIDS; Cohort study; HIV; Mortality; Particulate matter.

MeSH terms

Acquired Immunodeficiency Syndrome* / chemically induced
Acquired Immunodeficiency Syndrome* / epidemiology
Aged
Air Pollutants* / analysis
Air Pollution* / analysis
China / epidemiology
Cohort Studies
Environmental Exposure / adverse effects
HIV
Humans
Longevity
Middle Aged
Particulate Matter / analysis

Substances

Particulate Matter
Air Pollutants