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The findings support concerns that prescription opioids can weaken the immune system. Doctors who prescribe opioids need to reduce patients' risk of pneumonia through vaccination and by encouraging them to stop smoking, the researchers said.
For the study, a team from Yale University analyzed data from U.S. patients with and without HIV who were treated at Veterans Affairs medical facilities between 2000 and 2012.
Patients prescribed medium or high doses of opioid painkillers had a higher risk of pneumonia than those who did not take the medications, the findings showed. The risk was highest among those who took immunosuppressive opioids, such as codeine, fentanyl and morphine.
Patients with HIV were more likely to develop pneumonia even when taking low doses of opioids, and especially if they took immunosuppressive opioids, the investigators found.
"We saw that prescription opioids were independently associated with pneumonia requiring hospitalization," said corresponding author Dr. E. Jennifer Edelman, an associate professor at Yale School of Medicine.
Opioids are commonly prescribed to treat pain, especially among patients with HIV, the researchers noted. They believe this is the first study to look at how prescription opioids affect pneumonia risk in patients with HIV.
The report "lends credence to the hypothesis that opioids have effects on the immune system that are clinically relevant," Edelman said in a Yale news release.
The study was published Jan. 7 in JAMA Internal Medicine.
To reduce the risk of pneumonia, prescribers should consider lower doses of opioids or opioids that do not suppress the immune system, the researchers said. They also suggested that health care providers encourage pneumonia vaccination for patients, especially those with HIV.
-- Robert Preidt
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SOURCE: Yale University, news release, Jan. 7, 2019