NDLI: Association of exposure to air pollutants and risk of mortality among people living with HIV: a systematic review

Content Provider	Springer Nature : BioMed Central
Author	Padhi, Bijaya Kumar Khatib, Mahalaqua Nazli Ballal, Suhas Bansal, Pooja Bhopte, Kiran Gaidhane, Abhay M. Tomar, Balvir S. Ashraf, Ayash Kumar, M. Ravi Chauhan, Ashish Singh Sah, Sanjit Shabil, Muhammed Satapathy, Prakasini Jena, Diptismita Bushi, Ganesh Singh, Mahendra Pratap Chilakam, Nagavalli Pandey, Sakshi Brar, Manvinder Balaraman, Ashok Kumar Mehta, Rachana Daniel, Afukonyo Shidoiku
Abstract	Background People living with HIV (PLWH) are more vulnerable to infectious and non-infectious comorbidities due to chronic inflammation and immune dysfunction. Air pollution is a major global health risk, contributing to millions of deaths annually, primarily from cardiovascular and respiratory diseases. However, the link between air pollution and mortality risk in PLWH is underexplored. This systematic review assesses the association between exposure to pollutants such as particulate matter (PM), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO) and mortality risk in PLWH. Methods A systematic search of PubMed, Web of Science, and Embase was conducted for studies published up to August 2024. Eligibility criteria included cohort, case-control, and cross-sectional studies assessing air pollution exposure and mortality in PLWH. Nested-Knowledge software was used for screening and data extraction. The Newcastle-Ottawa Scale was applied for quality assessment. A narrative approach and tabular summarization were used for data synthesis and presentation. Results Nine studies, mostly from China, demonstrated a significant association between long-term exposure to PM1, PM2.5, and PM10 and increased risks of AIDS-related and all-cause mortality in PLWH. Hazard ratios for mortality increased by 2.38–5.13% per unit increase in PM concentrations, with older adults (> 60), females, and those with lower CD4 counts (< 500 cells/µL) being more vulnerable. Short-term exposure to ozone and sulfur dioxide also increased mortality risks, particularly during the warm season and in older populations. Specific pollutants like ammonium (NH4⁺) and sulfate (SO4²⁻) had the strongest links to elevated mortality. Conclusion Air pollution, especially fine particulate matter and ozone, is associated with a higher risk of mortality in PLWH. Targeted interventions to reduce pollution exposure in vulnerable subgroups are crucial. Further research is needed to confirm these findings in diverse regions and develop effective mitigation strategies.
Related Links	https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-024-20693-5.pdf
Ending Page	14
Page Count	14
Starting Page	1
File Format	HTM / HTML
ISSN	14712458
DOI	10.1186/s12889-024-20693-5
Journal	BMC Public Health
Issue Number	1
Volume Number	24
Language	English
Publisher	BioMed Central
Publisher Date	2024-11-22
Access Restriction	Open
Subject Keyword	Public Health Medicine Epidemiology Biostatistics Vaccine Environmental Health Air pollution People living with HIV Mortality Particulate matter Nitrogen dioxide Medicine/Public Health
Content Type	Text
Resource Type	Article
Subject	Public Health, Environmental and Occupational Health
Journal Impact Factor	3.5/2023
5-Year Journal Impact Factor	3.9/2023

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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