HIV leads to unique health concerns in older adults. Patients often exhibit comorbidities associated with older age sooner than those without HIV.
BC Lung Association research grant recipient Dr. Janice Leung is looking into why people with HIV end up with chronic lung diseases more often and at younger ages than the general population.
She is the first to explore the reasons for accelerated aging in the lungs. Her aim is to develop targeted treatment and prevention strategies for one of BC’s most vulnerable populations.
Twenty or thirty years ago, treatment for those with HIV focused on opportunistic lung infections, such as those caused by pneumonia bacteria. With antiretroviral therapy, these rates have fallen significantly.
While it is very good news people with HIV are living longer, we now face different challenges: HIV patients appear to suffer disproportionately from age-related chronic diseases such as COPD and lung cancer.
Dr. Leung is the first to study and compare samples of lung tissue from patients who passed away from HIV and patients without HIV. Specifically, she is looking for ways in which HIV lungs are different and why they seem to be aging faster.
While patient lung troubles were often attributed to smoking, cigarettes alone are not enough to explain the problem. The challenge is that traditional therapies for COPD, such as inhaled steroids, can sometimes react with certain HIV medications. Therefore, the options for treatment are more limited.
“Lung conditions appear to affect HIV patients earlier and with greater severity. It’s not uncommon in my clinic to see HIV patients in their 40s and 50s develop COPD and lung cancer. There aren’t as many drugs available to treat them and it’s vital we work on finding new therapies.”
Finding alternative therapies that will work in this population is imperative. Dr. Leung and her colleagues at the UBC Centre for Heart Lung Innovation have been looking at this problem since 2010. Current research is looking at differences in the bacterial communities between HIV and non-HIV patients in the lung and in the small intestine, to see if bacteria may be driving the destruction of the lung. Often with HIV, the lining of the small intestine becomes impaired. This means that bacteria may enter into the bloodstream where they can then travel to the lung and cause disease. And this might lead to permanent lung damage and early onset of diseases like COPD and cancer.
Through a better understanding of the lungs of patients with HIV, Dr. Leung’s research will help to find new drug treatments.
Dr. Leung is a respirologist who works at St. Paul’s Hospital in Vancouver. Her current research focus is in HIV and COPD. Dr. Leung graduated from the Medical School at Johns Hopkins University, Baltimore, Maryland, and did an internal residency there in 2009. She completed her respirology training at the University of Washington and Johns Hopkins University and also completed a critical care fellowship at the National Institute of Health.