Short-Term Exposure to PM_2.5 and O₃ Impairs Liver Function in HIV/AIDS Patients: Evidence from a Repeated...

Studies investigating the relationship between ambient air pollutants and liver function are scarce. Our objective was to examine the associations of acute exposure to PM_2.5 and O₃ with levels of hepatic enzymes in people living with HIV/AIDS (PWHA). Our study involved 163 PWHA, who were evaluated for serum hepatic enzymes up to four times within a year. We extracted daily average concentrations of PM_2.5, PM_2.5 components, and O₃ for each participant, based on their residential address, using the Tracking of Air Pollution in China database. Linear mixed-effect models were utilized to assess the associations of acute exposure to PM_2.5 and O₃ with hepatic enzymes. Weighted quantile sum regression models were employed to identify the major constituents of PM_2.5 that affect hepatic enzymes. The percent change of aspartate aminotransferase (AST) concentration was positively correlated with a 10 µg/m³ increase in PM_2.5, ranging from 1.92 (95% CI: 3.13 to 4.38) to 6.09 (95% CI: 9.25 to 12.38), with the largest effect observed at lag06. Additionally, acute O₃ exposure was related to increased levels of alanine aminotransferase (ALT), AST, and alkaline phosphatase (ALP) concentrations. Co-exposure to high levels of PM_2.5 and O₃ had an antagonistic effect on the elevation of AST. Further analysis revealed that SO₄^2- and BC were major contributors to elevated AST concentration due to PM_2.5 constituents. A stronger association was found between O₃ exposure and ALT concentration in female PWHA. Our study found that short-term exposure to PM_2.5 and O₃ was associated with increased levels of hepatic enzymes, indicating that PM_2.5 and O₃ exposure may contribute to hepatocellular injury in PWHA. Our study also found that PWHA may be more vulnerable to air pollution than the general population. These findings highlight the relationship between air pollutants and liver function in PWHA, providing a scientific basis for the implementation of measures to protect susceptible populations from the adverse effects of air pollution. A reduction in the burning of fossil fuels and reduced exposure to air pollutants may be effective hazard reduction approaches.