Prevalence of obstructive lung disease in HIV population: A cross sectional study (original) (raw)
Frequency of HIV in Obstructive Lung Disease Patients
The International Journal of Frontier Sciences, 2018
Background: Obstructive lung disease (OLD) is one of the main causes of mortality and morbidity worldwide. Obstructive lung disease is the narrowing of bronchioles mainly due to excessive smooth muscle contraction. The objective of this study is to evaluate the Frequency of HIV in obstructive lung disease patients.Methodology: Samples were collected randomly, and study was completed in almost six months. 100 samples were taken with an informed consent taken from all the patients. EDTA and Clotted blood was collected for HIV ELISA and HIV screening.Results: In this study, 69% Males and 31%Females, 34% Smokers, 26% patients were Hypertensive, 10% patients were diabetic, 3% patients were diagnosed HIV positive by screening and ELISA.Conclusion: The frequency of HIV in obstructive lung disease patients in this research is not very high as compared to the previous researches, showing high frequency and relationship between HIV and obstructive lung disease patients. The reason behind low ...
The Spectrum of Pulmonary Disease in Patients with HIV Infection
Canadian Journal of Infectious Diseases, 1994
Pneumocystis carinii pneumonia (PCP) and Kaposi’s sarcoma were the harbingers of the HIV epidemic more than 10 years ago. Since then. the spectrum of pulmonary disease associated with HIV infection has become better understood. Although most of these conditions are infectious in nature. neoplastic and inflammatory processes also occur with increased frequency. The most common infectious pulmonary diseases include PCP. Mycobacterium tuberculosis infection and pyogenic bacterial pneumonia secondary to Streptococcus pneumoniae. Haemophilus influenzae or Staphylococcus aureus. Among the noninfectious causes of pulmonary disease. the most common are Kaposi's sarcoma. airways hyper-reactive disease (asthma) and emphysema. Respiratory involvement in HIV-infected individuals is not always related to the HIV infection. These patients often present with pulmonary disorders that are common in the genernal population. Differential diagnosis of respiratory conditions is significantly facilit...
COPD: Journal of Chronic Obstructive Pulmonary Disease, 2020
In Sub-Saharan Africa, COPD remains prevalent but its association with HIV is not well characterized especially in rural settings. We assessed for COPD prevalence, associated factors and lung function profile among HIV-infected individuals attending ART clinics in rural Nakaseke district of Uganda. We enrolled HIV-positive participants from four HIV treatment centers in rural Uganda. Participants underwent spirometry testing following standard guidelines. We defined COPD as a post-bronchodilator FEV1/ FVC ratio less than the fifth percentile of the NHANES III African-American reference. We assessed for factors associated with COPD and lung function profiles using multivariable logistic and linear regression analyses. We analyzed data from 722 HIV-positive participants (mean age 48.0 years, 59.7% women). Over 90% of participants were on ART for a median duration of 4 years (IQR 2–7 years), with a median viral load of 0 copies/mL (IQR 0–0 copies/mL), current and baseline CD4+T cell count of 478 cells/mm3 (IQR 346–663 cells/mm3) and 335 cells/mm3 (IQR 187–523 cells/mm3) respectively. The prevalence of COPD was 6.22%. COPD was associated with worse respiratory symptoms and health status. History of pulmonary tuberculosis was strongly associated with COPD (adjusted OR=4.92, 95% CI 1.71 to 14.15, p=0.003) and reduced lung function. Use of ART, CD4+T cell count and viral load were not associated with COPD or reduced lung function. In conclusion, we report a COPD prevalence of 6.22% in HIV-infected individuals in rural Uganda. Pulmonary tuberculosis remains the strongest predictor of COPD risk and reduced lung function in well-controlled HIV.
Pulmonary symptoms and diagnoses are associated with HIV in the MACS and WIHS cohorts
BMC Pulmonary Medicine, 2014
Background: Several lung diseases are increasingly recognized as comorbidities with HIV; however, few data exist related to the spectrum of respiratory symptoms, diagnostic testing, and diagnoses in the current HIV era. The objective of the study is to determine the impact of HIV on prevalence and incidence of respiratory disease in the current era of effective antiretroviral treatment. Methods: A pulmonary-specific questionnaire was administered yearly for three years to participants in the Multicenter AIDS Cohort Study (MACS) and Women's Interagency HIV Study (WIHS). Adjusted prevalence ratios for respiratory symptoms, testing, or diagnoses and adjusted incidence rate ratios for diagnoses in HIV-infected compared to HIV-uninfected participants were determined. Risk factors for outcomes in HIV-infected individuals were modeled. Results: Baseline pulmonary questionnaires were completed by 907 HIV-infected and 989 HIV-uninfected participants in the MACS cohort and by 1405 HIV-infected and 571 HIV-uninfected participants in the WIHS cohort. In MACS, dyspnea, cough, wheezing, sleep apnea, and incident chronic obstructive pulmonary disease (COPD) were more common in HIV-infected participants. In WIHS, wheezing and sleep apnea were more common in HIV-infected participants. Smoking (MACS and WIHS) and greater body mass index (WIHS) were associated with more respiratory symptoms and diagnoses. While sputum studies, bronchoscopies, and chest computed tomography scans were more likely to be performed in HIV-infected participants, pulmonary function tests were no more common in HIV-infected individuals. Respiratory symptoms in HIV-infected individuals were associated with history of pneumonia, cardiovascular disease, or use of HAART. A diagnosis of asthma or COPD was associated with previous pneumonia. Conclusions: In these two cohorts, HIV is an independent risk factor for several respiratory symptoms and pulmonary diseases including COPD and sleep apnea. Despite a higher prevalence of chronic respiratory symptoms, testing for non-infectious respiratory diseases may be underutilized in the HIV-infected population.
HIV-AIDS patients with respiratory manifestation: study at tertiary care center
International Journal of Advances in Medicine, 2017
Background: HIV affects virtually all organ systems in the body. Pulmonary disease is one of the most frequent complications of HIV infection. It is found in mostly married, young and middle aged, urban poor with male preponderance and heterosexual and blood transfusion being the commonest source of infection. Prompt diagnosis and early management may hasten the clinical recovery and reduce the risk and severity of toxic drug effects. Moreover knowledge regarding the incidence and early manifestations may help in developing strategies regarding prophylactic therapy of various infections of respiratory system. Aim of this study was to find the Incidence, occurrence and pattern of respiratory infections in HIV infected patients, use of various drugs used and response of therapy in respiratory infections and to study impact of HAART in PLHA with respiratory infection. Methods: Fifty HIV infected patients showing clinical evidence of respiratory system involvement and admitted in our h...
American Journal of Respiratory and Critical Care Medicine, 2010
Rationale: Before the introduction of combination antiretroviral (ARV) therapy, patients infected with HIV had an increased prevalence of respiratory symptoms and lung function abnormalities. The prevalence and exact phenotype of pulmonary abnormalities in the current era are unknown. In addition, these abnormalities may be underdiagnosed. Objectives: Our objective was to determine the current burden of respiratory symptoms, pulmonary function abnormalities, and associated risk factors in individuals infected with HIV. Methods: Cross-sectional analysis of 167 participants infected with HIV who underwent pulmonary function testing. Measurements and Main Results: Respiratory symptoms were present in 47.3% of participants and associated with intravenous drug use (odds ratio [OR] 3.64; 95% confidence interval [CI], 1.32-10.046; P 5 0.01). Only 15% had previous pulmonary testing. Pulmonary function abnormalities were common with 64.1% of participants having diffusion impairment and 21% having irreversible airway obstruction. Diffusion impairment was independently associated with ever smoking (OR 2.46; 95% CI, 1.16-5.21; P 5 0.02) and Pneumocystis pneumonia prophylaxis (OR 2.94; 95% CI, 1.10-7.86; P 5 0.01), whereas irreversible airway obstruction was independently associated with pack-years smoked (OR 1.03 per pack-year; 95% CI, 1.01-1.05; P , 0.01), intravenous drug use (OR 2.87; 95% CI, 1.15-7.09; P 5 0.02), and the use of ARV therapy (OR 6.22; 95% CI, 1.19-32.43; P 5 0.03). Conclusions: Respiratory symptoms and pulmonary function abnormalities remain common in individuals infected with HIV. Smoking and intravenous drug use are still important risk factors for pulmonary abnormalities, but ARV may be a novel risk factor for irreversible airway obstruction. Obstructive lung disease is likely underdiagnosed in this population.
HIV-associated lung infections and complications in the era of combination antiretroviral therapy
Proceedings of the American Thoracic Society, 2011
The spectrum of lung diseases associated with HIV is broad, and many infectious and noninfectious complications of HIV infection have been recognized. The nature and prevalence of lung complications have not been fully characterized since the Pulmonary Complications of HIV Infection Study more than 15 years ago, before antiretroviral therapy (ART) increased life expectancy. Our understanding of the global epidemiology of these diseases in the current ART era is limited, and the mechanisms for the increases in the noninfectious conditions, in particular, are not well understood. The Longitudinal Studies of HIV-Associated Lung Infections and Complications (Lung HIV) Study (ClinicalTrials.gov number NCT00933595) is a collaborative multi-R01 consortium of research projects established by the National Heart, Lung, and Blood Institute to examine a diverse range of infectious and noninfectious pulmonary diseases in HIV-infected persons. This article reviews our current state of knowledge o...
Chronic lung disease in children and adolescents with HIV: a case–control study
Tropical Medicine & International Health, 2020
Objective: To describe the features of HIV-associated chronic lung disease (CLD) in older children and adolescents living with HIV and to examine the clinical factors associated with CLD. This is a post-hoc analysis of baseline data from the BREATHE clinical trial (ClinicalTrials.gov, NCT02426112). Methods: Children and adolescents aged 6-19 years were screened for CLD (defined as a FEV1 z-score <-1 with no reversibility post-bronchodilation with salbutamol) at two HIV clinics in Harare, Zimbabwe and Blantyre, Malawi. Eligible participants with CLD (cases) were enrolled, together with a control group without CLD (frequency-matched by age group and duration on ART) in a 4:1 allocation ratio. A clinical history and examination was undertaken. The association between CLD and a priori-defined demographic and clinical covariates was investigated using multivariable logistic regression. Results: Of the 1,585 participants screened, 419 (32%) had a FEV 1 z-score <-1, of whom 347 were enrolled as cases (median age 15.3 years [IQR 12.7-17.7]; 48.9% female), and 74 with FEV1 z-score>0 as controls (median age 15.6 years [IQR 12.1-18.2]; 62.2% female). Amongst cases, current respiratory symptoms including cough and shortness of breath were reported infrequently (9.3% and 1.8%, respectively). However, 152 (43.8%) of cases had a respiratory rate above the 90th centile for their age. Wasting and
Significant chronic airway abnormalities in never‐smoking HIV ‐infected patients
HIV Medicine, 2019
The aim of the study was to describe chronic lung disease in HIV-infected never-smokers by looking at clinical, structural and functional abnormalities. Methods This comparative cross-sectional study included 159 HIV-infected never-smoking patients [mean (AE standard deviation) age 54.6 AE 9.1 years; 13.2% female; 98.1% with undetectable viral load] and 75 nonmatched never-smoking controls [mean (AE standard deviation) age 52.6 AE 6.9 years; 46.7% female]. We examined calcium scoring computer tomography (CT) scans or chest CT scans, all with a lung-dedicated algorithm reconstruction, to assess emphysema and airway disease (respiratory bronchiolitis and/or bronchial wall thickening), tested pulmonary function using spirometry, lung volumes and the diffusion lung capacity of carbon monoxide (DLCO), and assessed respiratory symptoms using the Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT). Results Twenty-five (17.2%) of the HIV-infected patients versus two (2.7%) of the controls had a CAT score > 10. Only 5% of the HIV-infected patients showed FEV1% < 80%, and 25% had DLCO < 75% of the predicted value. Based on the CT scans, they had increased prevalences, compared with the controls, of airway disease (37% versus 7.9%, respectively) and emphysema (18% versus 4%, respectively), with more severe and more frequent centrilobular disease. After correction for age, sex and clinical factors, HIV infection was significantly associated with CAT > 10 [odds ratio (OR) 7.7], emphysema (OR 4), airway disease (OR 4.5) and DLCO < 75% of predicted (OR 4). Conclusions Although comparisons were limited by the different enrolment methods used for HIV-infected patients and controls, the results suggest that never-smoking HIV-infected patients may present with chronic lung damage characterized by CT evidence of airway disease. A minority of them showed respiratory symptoms, without significant functional abnormalities.