Abstract
Purpose
The objective of our study was to evaluate the presence of respiratory symptoms and chronic obstructive pulmonary disease (COPD) in a human immunodeficiency virus (HIV)-infected outpatient population and to further investigate the role of highly active antiretroviral therapy (HAART) and other possibly associated risk factors.
Methods
We consecutively enrolled in a cross-sectional study HIV-infected patients and HIV-negative age, sex and smoking status matched controls. All participants completed a questionnaire for pulmonary symptoms and underwent a complete spirometry.
Results
We enrolled 111 HIV-infected patients and 65 HIV-negative age- and sex-matched controls. HIV-infected patients had a significantly higher prevalence of any respiratory symptom (p = 0.002), cough (p = 0.006) and dyspnoea (p = 0.02). HIV-infected patients also had a significantly higher prevalence of COPD in respect of HIV-negative controls (p = 0.008). Furthermore, HIV-infected individuals had significantly (p = 0.002) lower forced expiratory volume at one second (FEV1) and FEV1/forced vital capacity (FVC) ratio (Tiffeneau index) (p = 0.028), whereas the total lung capacity (TLC) was significantly higher (p = 0.018). In the multivariate analysis, significant predictors of respiratory symptoms were current smoking [adjusted odds ratio (AOR) 11.18; 95 % confidence interval (CI) 3.89–32.12] and previous bacterial pneumonia (AOR 4.41; 95 % CI 1.13–17.13), whereas the only significant predictor of COPD was current smoking (AOR 5.94; 95 % CI 1.77–19.96). HAART receipt was not associated with respiratory symptoms nor with COPD.
Conclusions
We evidenced a high prevalence of respiratory symptoms and COPD among HIV-infected patients. HIV infection, current cigarette smoking and previous bacterial pneumonia seem to play a significant role in the development of respiratory symptoms and COPD. Thus, our results suggest that the most at-risk HIV-infected patients should be screened for COPD to early identify those who may need specific treatment.
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Acknowledgements
We thank all the patients who participated in our study and all the nurses and physicians involved in the enrollment of patients.
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The authors declare no conflict of interest.
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Madeddu, G., Fois, A.G., Calia, G.M. et al. Chronic obstructive pulmonary disease: an emerging comorbidity in HIV-infected patients in the HAART era?. Infection 41, 347–353 (2013). https://doi.org/10.1007/s15010-012-0330-x
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DOI: https://doi.org/10.1007/s15010-012-0330-x