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We hypothesised that PLWH receiving antiretroviral therapy (ART) have faster lung function decline than matched controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a prospective matched cohort study by including ART-treated PLWH from the Copenhagen Co-morbidity in HIV Infection Study (n=705) and the INSIGHT Strategic Timing of Antiretroviral Treatment Pulmonary Substudy (n=425) and frequency matched population controls from the Copenhagen General Population Study (n=2895) in a 1:3 ratio. Eligible participants were \u226525 years old and had two spirometry tests separated by at least 2 years of follow-up. Forced expiratory volume in 1 s (FEV<jats:sub>1<\/jats:sub>) decline (mL\/year) was compared between PLWH and controls using a linear mixed model adjusted for age, sex, ethnicity and smoking status. Effect modification by smoking was investigated in subgroup analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The majority of PLWH were virally suppressed (96.1%). The adjusted mean annual decline in FEV<jats:sub>1<\/jats:sub>was faster in PLWH than in controls with 36.4 (95% CI 33.7 to 39.1) vs 27.9 (95% CI 26.9 to 28.8) mL\/year, yielding a difference of 8.5 (95% CI 5.6 to 11.4) mL\/year. The association between HIV and FEV<jats:sub>1<\/jats:sub>decline was modified by smoking, with the largest difference in current smokers (difference: 16.8 (95% CI 10.5 to 23.0) mL\/year) and the smallest difference in never-smokers (difference: 5.0 (95% CI 0.7 to 9.3) mL\/year). FEV<jats:sub>1<\/jats:sub>decline &gt;40 mL\/year was more prevalent in PLWH (adjusted OR: 1.98 (95% CI 1.67 to 2.34)).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Well-treated PLWH have faster lung function decline than controls and smoking seems to modify this association, suggesting that smoking may lead to more rapid lung function decline in PLWH than in controls.<\/jats:p><\/jats:sec>","DOI":"10.1136\/thorax-2022-218910","type":"journal-article","created":{"date-parts":[[2023,1,13]],"date-time":"2023-01-13T18:26:04Z","timestamp":1673634364000},"page":"535-542","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Faster lung function decline in people living with HIV despite adequate treatment: a longitudinal matched cohort study"],"prefix":"10.1136","volume":"78","author":[{"given":"Rebekka Faber","family":"Thudium","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Ronit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1442-4694","authenticated-orcid":false,"given":"Shoaib","family":"Afzal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunus","family":"\u00c7olak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie Lyng","family":"Forman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Mendo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicente","family":"Estrada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nagalingeswaran","family":"Kumarasamy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00f8rge G","family":"Nordestgaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Lundgren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f8rgen","family":"Vestbo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8644-2827","authenticated-orcid":false,"given":"Ken M","family":"Kunisaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne Dam","family":"Nielsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,1,13]]},"reference":[{"key":"2024051320295570000_78.6.535.1","doi-asserted-by":"crossref","first-page":"e193","DOI":"10.1016\/S2214-109X(17)30451-5","article-title":"Prevalence of chronic obstructive pulmonary disease in the global population with HIV: a systematic review and meta-analysis","volume":"6","author":"Bigna","year":"2018","journal-title":"Lancet Glob Health"},{"key":"2024051320295570000_78.6.535.2","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1513\/AnnalsATS.201606-492OC","article-title":"Decreased lung function and all-cause mortality in HIV-infected individuals","volume":"15","author":"Gingo","year":"2018","journal-title":"Ann Am Thorac Soc"},{"key":"2024051320295570000_78.6.535.3","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1097\/QAI.0000000000002431","article-title":"Association of lung function with HIV-related quality of life and health care utilization in a high-risk cohort","volume":"85","author":"Raju","year":"2020","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2024051320295570000_78.6.535.4","doi-asserted-by":"crossref","unstructured":"Rowell-Cunsolo TL , Hu G , Bellerose M . 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