• CAC
• emphysema
• HIV
• packyear
• smoke

ABSTRACT (350 words)
Background:
The objective is to compare active smoking habits versus pack year to predict lung and heart disease in HIV-Infected Individuals.
Methodology:
Thoracic CT scans of 903 patients (pts) infected with HIV (mean age 48 ±7 yrs, 29% females) were reviewed by 3 radiologists by consensus. Patients were analysed according to smoking status and pack years. Individuals known to have active lung or heart disease at the time of CT scanning were excluded. We divided the population in 7 groups: A (never smoked), B (previous smoker with pack year ≤10), C (previous smoker with pack year 11-20), D (previous smoker with pack year >20), E (current smoker with pack year ≤10), F (current smoker with pack year 11-20), G (current smoker with pack year >20). Multimorbidity lung and heart disease (MLHD) was defined by the presence of >2 lung or heart abnormalities on the CT scan.
Results:
Prevalence of lung abnormalities were: 326 pts (36.1%) with emphysema, 271 (30.0%) with bronchiolitis, 44 (4.9%) with non-calcified lung nodules, 568 (63%) with significant bronchial wall thickening, 150 (16.7%) with bronchiectasis, 9 (1%) with interstitial lung disease. Overall, 445 pts (49.3%) had >2 lung abnormalities.
Imaging findings suggestive of prior myocardial infarction (MI) were found in 1.4% (13 pts); 26.6% (240 pts) had CAC scores of 1 to 100, and 9.8% (89 pts) had CAC>100. 13.6% (123 pts) of the patients had CAC>100 and/or previous MI. MLHD was present in 484 pts (53.6%) and among 78 pts (16%) who never smoked.
MLHD increased proportionally to pack-year in both current and previous smokers (figure 1). Probability of MLHD increases with pack-year independently of smoking status (figure 2).
Independent predictors for MLHD were: age (OR=2.15, CI:1.71-2.69), sex (OR=1.62, CI:1.15-2.26) and group C (OR= 2.43, CI:1.47-4.03), D (OR=5.37, CI:3.39-8.51) and G (OR=2.02, CI:1.17-3.49) comparing to group A.
Conclusions: MLHD is common in HIV-infected individuals even in never-smokers.
This condition is better predicted by pack year than active smoke habits.
Previous smokers with high pack year are at higher risk for MLHD and we may hypothesize that this disease burden contributed to the decision to stop smoking.

ABSTRACT (350 words) Background: The objective is to compare active smoking habits versus pack year to predict lung and heart disease in HIV-Infected Individuals. Methodology: Thoracic CT scans of 903 patients (pts) infected with HIV (mean age 48 ±7 yrs, 29% females) were reviewed by 3 radiologists by consensus. Patients were analysed according to smoking status and pack years. Individuals known to have active lung or heart disease at the time of CT scanning were excluded. We divided the population in 7 groups: A (never smoked), B (previous smoker with pack year ≤10), C (previous smoker with pack year 11-20), D (previous smoker with pack year >20), E (current smoker with pack year ≤10), F (current smoker with pack year 11-20), G (current smoker with pack year >20). Multimorbidity lung and heart disease (MLHD) was defined by the presence of >2 lung or heart abnormalities on the CT scan. Results: Prevalence of lung abnormalities were: 326 pts (36.1%) with emphysema, 271 (30.0%) with bronchiolitis, 44 (4.9%) with non-calcified lung nodules, 568 (63%) with significant bronchial wall thickening, 150 (16.7%) with bronchiectasis, 9 (1%) with interstitial lung disease. Overall, 445 pts (49.3%) had >2 lung abnormalities. Imaging findings suggestive of prior myocardial infarction (MI) were found in 1.4% (13 pts); 26.6% (240 pts) had CAC scores of 1 to 100, and 9.8% (89 pts) had CAC>100. 13.6% (123 pts) of the patients had CAC>100 and/or previous MI. MLHD was present in 484 pts (53.6%) and among 78 pts (16%) who never smoked. MLHD increased proportionally to pack-year in both current and previous smokers (figure 1). Probability of MLHD increases with pack-year independently of smoking status (figure 2). Independent predictors for MLHD were: age (OR=2.15, CI:1.71-2.69), sex (OR=1.62, CI:1.15-2.26) and group C (OR= 2.43, CI:1.47-4.03), D (OR=5.37, CI:3.39-8.51) and G (OR=2.02, CI:1.17-3.49) comparing to group A. Conclusions: MLHD is common in HIV-infected individuals even in never-smokers. This condition is better predicted by pack year than active smoke habits. Previous smokers with high pack year are at higher risk for MLHD and we may hypothesize that this disease burden contributed to the decision to stop smoking.