Rx Opioids Up Pneumonia Risk in Patients With, Without HIV
Risk greatest with higher-dose opioids and opioids with immunosuppressive properties
MONDAY, Jan. 7, 2019 (Pharmacist's Briefing) -- Prescribed opioids are associated with an increased risk for community-acquired pneumonia (CAP) requiring hospitalization among persons with and without HIV, according to a study published online Jan. 7 in JAMA Internal Medicine.
E. Jennifer Edelman, M.D., from the Yale School of Medicine in New Haven, Connecticut, and colleagues assessed the association of prescribed opioids with CAP by opioid type and HIV status in a nested case-control study using data from the Veterans Aging Cohort Study (25,392 participants; 2000 through 2012).
The researchers found that the greatest CAP risk was associated with current medium doses of opioids with unknown or no immunosuppressive properties (adjusted odds ratio [aOR], 1.35) and with immunosuppressive properties (aOR, 2.07) as well as current high doses of opioids with unknown or no immunosuppressive properties (aOR, 2.07) and with immunosuppressive properties (aOR, 3.18) compared with no prescribed opioids or any past prescribed opioid with no immunosuppressive properties (aOR, 1.24) and with immunosuppressive properties (aOR, 1.42), especially with current receipt of immunosuppressive opioids. CAP risk was consistently higher among individuals living with HIV with current prescribed opioids, particularly immunosuppressive opioids, compared with uninfected patients (aORs for current immunosuppressive opioids with medium dose, 1.76 versus 2.33).
"[The study] lends credence to the hypothesis that opioids have effects on the immune system that are clinically relevant," Edelman said in a statement.