Prevalence of obstructive lung disease in HIV population: a cross sectional study |
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Authors: | Hirani Amyn Cavallazzi Rodrigo Vasu Tajender Pachinburavan Monvasi Kraft Walter K Leiby Benjamin Short William Desimone Joseph Squires Kathleen E Weibel Sandra Kane Gregory C |
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Affiliation: | aDivision of Pulmonary and Critical Care Medicine, Thomas Jefferson University, Philadelphia, PA, USA;bDivision of Infectious Diseases,Thomas Jefferson University, Philadelphia, PA, USA;cDepartment of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA, USA |
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Abstract: | BackgroundObservational studies have suggested an association between HIV infection and emphysema.AimsThe primary aim of this study was to estimate the prevalence of obstructive lung disease in HIV-infected patients seen in an outpatient infectious disease clinic. The secondary aim was to estimate the prevalence of Obstructive Lung Disease (OLD) in smokers and non smokers in this population.MethodsThis was a prospective cross-sectional study. Consecutive patients who were seen for routine HIV care underwent spirometry and answered the St. George’s Respiratory Questionnaire (SGRQ). Further, we collected information from the charts on demographics, co-morbidities, CD4 cell count, and HIV viral load (current, baseline, etc).ResultsThis study included 98 HIV-infected patients with mean age of 45 years, (SD: 11) and 84% male. They were seen from November 2008 to May 2009 at Thomas Jefferson University in Philadelphia. According to established criteria, spirometry results were classified as normal in 69% and obstructive in 16.3%. Among those who never smoked, the prevalence of obstructive lung disease on spirometry was 13.6%. The prevalence of obstruction in HIV patients with a history of smoking was 18.5%. Current and ever smokers comprised 21.4% and 55% of the patients respectively. The mean SGRQ total score was 7. The mean SGRQ score in active smokers was 17 and 15 in those subjects with a prior history of smoking. The mean SGRQ score among patients with obstruction in spiromerty was 27.7 in patients with obstruction on spirometry.ConclusionThis urban population of HIV-infected persons has a relatively high prevalence of obstructive lung disease as assessed by spirometry. Furthermore, the high prevalence of obstructive lung disease in never smokers may suggest a possible association between HIV infection and emphysema. In addition the SGRQ total score was comparatively higher in patients with obstruction on spirometry. Our data suggests that potentially all patients with HIV should be screened a for OLD. |
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Keywords: | HIV Obstructive lung disease COPD Spirometry Emphysema |
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