Global lung health: the colliding epidemics of tuberculosis, tobacco smoking, HIV and COPD

Tuberculosis (TB), smoking, HIV and chronic obstructive pulmonary disease (COPD) are burgeoning epidemics in developing countries. The link between TB and HIV is well established. Less well recognised is the strong relationship between tobacco smoking and the development and natural history of TB. T...

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Published in:The European respiratory journal Vol. 35; no. 1; p. 27
Main Authors: van Zyl Smit, R N, Pai, M, Yew, W W, Leung, C C, Zumla, A, Bateman, E D, Dheda, K
Format: Journal Article
Language:English
Published: England 01.01.2010
Subjects:
Global Health
HIV Infections - epidemiology
Humans
Pulmonary Disease, Chronic Obstructive - epidemiology
Smoking - epidemiology
Tuberculosis, Pulmonary - epidemiology
ISSN:1399-3003, 1399-3003
Online Access:Get more information
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Summary:Tuberculosis (TB), smoking, HIV and chronic obstructive pulmonary disease (COPD) are burgeoning epidemics in developing countries. The link between TB and HIV is well established. Less well recognised is the strong relationship between tobacco smoking and the development and natural history of TB. These associations are of considerable relevance to public health and disease outcomes in individuals with TB. Moreover, tobacco smoking, a modifiable risk factor, is associated with poorer outcomes in HIV-associated opportunistic infections, of which TB is the commonest in developing countries. It is now also becoming clear that TB, like tobacco smoke, besides its known consequences of bronchiectasis and other pulmonary morbidity, is also a significant risk factor for the development of COPD. Thus, there is a deleterious and synergistic interaction between TB, HIV, tobacco smoking and COPD in a large proportion of the world's population. Further work, specifically mechanistic and epidemiological studies, is required to clarify the role of tobacco smoke on the progression of TB and HIV infection, and to assess the impact of smoking cessation interventions. These interactions deserve urgent attention and have major implications for coordinated public health planning and policy recommendations in the developing world.
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ISSN:1399-3003
1399-3003
DOI:10.1183/09031936.00072909