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RATIONALE: Multiple studies have demonstrated an increased risk of chronic obstructive pulmonary disease (COPD) in heterozygous carriers of the AAT (alpha-1 antitrypsin) Z allele. However, it is not known if MZ subjects with COPD are phenotypically different from noncarriers (MM genotype) with COPD. OBJECTIVES: To assess if MZ subjects with COPD have different clinical features compared with MM subjects with COPD. METHODS: Genotypes of SERPINA1 were ascertained by using whole-genome sequencing data in three independent studies. We compared outcomes between MM subjects with COPD and MZ subjects with COPD in each study and combined the results in a meta-analysis. We performed longitudinal and survival analyses to compare outcomes in MM and MZ subjects with COPD over time. MEASUREMENTS AND MAIN RESULTS: We included 290 MZ subjects with COPD and 6,184 MM subjects with COPD across the three studies. MZ subjects had a lower FEV(1)% predicted and greater quantitative emphysema on chest computed tomography scans compared with MM subjects. In a meta-analysis, the FEV(1) was 3.9% lower (95% confidence interval [CI], −6.55% to −1.26%) and emphysema (the percentage of lung attenuation areas

Advances in HIV treatments have led to a greater focus on health-related quality of life (HRQOL) among people living with HIV/AIDS. The current study examined HRQOL among women living with HIV/AIDS, with a special emphasis on the roles of personal and household members’ alcohol and drug use. Women in HIV care (N=378) completed a comprehensive assessment. HRQOL was measured using a modified version of the 12-Item Short Form Health Survey (SF-12); scores were derived for the mental and physical composite summaries (MCS and PCS, respectively; lower scores reflect poorer HRQOL). The Alcohol Use Disorders Identification Test (AUDIT), the Risk Assessment Battery and the 90-day Timeline Followback (TLFB) were used to measure recent alcohol and drug use. Household members’ substance use were assessed by asking participants about the alcohol/drug status of persons with whom they live. Multivariate generalized linear models were used to estimate the linear association between MCS and PCS scores and demographic characteristics, and personal and household members’ alcohol and drug use. We found lower MCS scores were significantly associated with personal alcohol use, lower income, not being African American, and living with someone with alcohol or/and drug problems. Lower PCS scores were significantly associated with older age and being divorced, separated or widowed. Compared to never married, being married was associated with higher PCS scores. Findings indicate that personal alcohol use and household members’ substance use are independently associated with lower mental HRQOL. Universal screening and targeted interventions for alcohol use by the patient or household members may offer potential strategies for improving mental health quality of life among women living with HIV/AIDS.