Prevalence of chronic obstructive pulmonary disease in patients diagnosed with HIV without prior antiretroviral treatment

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is the most prevalent respiratory problem in the world. Patients with human immunodeficiency virus (HIV) infection have a higher prevalence of smoking and recurrent lung infections and are at higher risk of COPD. Objective: To determine the prevalence of COPD in HIV-diagnosed patients referred to an infectious diseases hospital. Method: Individuals with HIV infection without previous or ongoing antiretroviral treatment, with chronic respiratory symptoms, with or without a history of exposure for the development of COPD were included. Pre-and post-bronchodilation spirometry, high-resolution computed tomography, viral load determination and CD4 count were carried out. Spirometry measurements were compared with Wilcoxon's test. Results: Sixty-six HIV-diagnosed patients, with a mean age of 31.5 years were included; 64 were males and two females. The prevalence of COPD was 7.6 %. The group with obstruction had a lower CD4 count (27.3 versus 225.9) and higher viral load (165,000 versus 57,722), in comparison with the group without obstruction. A positive correlation was observed between lower viral load and higher forced expiratory volume in 1 second/ forced vital capacity ratio. Conclusion: HIV-positive patients with a lower CD4 count and a higher viral load show a decrease in spirometry values.

Prevalence and incidence of chronic obstructive pulmonary disease in Latin America and the Caribbean: a systematic review and meta-analysis

“…The mean age ranged from 49.8 to 65.3. The countries in which the studies were conducted were Brazil [ 20 , 23 , 27 , 29 , 33 , 37 – 39 ], Mexico [ 24 , 28 – 30 , 34 ], Argentina [ 25 , 26 , 31 , 32 ] Uruguay [ 25 , 26 , 29 , 32 ], Chile [ 26 , 29 , 32 ], Colombia [ 21 , 25 , 35 ], Peru [ 22 ], and Trinidad and Tobago [ 36 ]. Thirteen studies were conducted in the general population [ 21 , 22 , 24 , 26 , 28 – 33 , 36 , 37 , 39 ] four in hospitals [ 20 , 34 , 35 , 38 ] and three in primary care centers [ 23 , 25 , 27 ].…”

“…The countries in which the studies were conducted were Brazil [ 20 , 23 , 27 , 29 , 33 , 37 – 39 ], Mexico [ 24 , 28 – 30 , 34 ], Argentina [ 25 , 26 , 31 , 32 ] Uruguay [ 25 , 26 , 29 , 32 ], Chile [ 26 , 29 , 32 ], Colombia [ 21 , 25 , 35 ], Peru [ 22 ], and Trinidad and Tobago [ 36 ]. Thirteen studies were conducted in the general population [ 21 , 22 , 24 , 26 , 28 – 33 , 36 , 37 , 39 ] four in hospitals [ 20 , 34 , 35 , 38 ] and three in primary care centers [ 23 , 25 , 27 ]. Concerning the type of population, both Moreira et al and Ramirez-Venegas et al were studies conducted only in the female population [ 20 , 30 ]; Romero-Lopez et al conducted the study in people with HIV [ 34 ].…”

“…Thirteen studies were conducted in the general population [ 21 , 22 , 24 , 26 , 28 – 33 , 36 , 37 , 39 ] four in hospitals [ 20 , 34 , 35 , 38 ] and three in primary care centers [ 23 , 25 , 27 ]. Concerning the type of population, both Moreira et al and Ramirez-Venegas et al were studies conducted only in the female population [ 20 , 30 ]; Romero-Lopez et al conducted the study in people with HIV [ 34 ]. Three studies were conducted in an older adult population [ 20 , 27 , 35 ].…”

HIV and chronic lung disease

“…The propensity of PLWH toward COPD was first noted in 1992 when Diaz and colleagues reported 4 PLWH who had emphysema-like bullous changes, air trapping, hyperinflation, and reduced diffusion capacity, but no previous history of pulmonary infections [40]. Since then, in the cART era, the estimated prevalence of COPD has ranged between as low as less than 5% to upwards of 60% of cohorts, with definitions as varied as self-report [41,42], spirometry-confirmed [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59], computed tomography (CT) presence of emphysema [60][61][62][63][64][65][66][67], International Classification of Diseases (ICD) diagnostic codes [68][69][70][71][72][73][74][75][76][77], or chart review [78,79]. A 2018 meta-analysis reported pooled prevalence values of 10.5-10.6% by spirometry, 5.6% by ICD diagnostic codes, and 8.7% by patient selfreport [80].…”