Abstract
BackgroundSeveral 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.MethodsA 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.ResultsBaseline 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.ConclusionsIn 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.
Highlights
Several lung diseases are increasingly recognized as comorbidities with HIV; few data exist related to the spectrum of respiratory symptoms, diagnostic testing, and diagnoses in the current HIV era
Chronic lung conditions may contribute to morbidity and mortality as conditions such as chronic obstructive pulmonary disease (COPD), [1,6,7] bronchogenic carcinoma, [8] pulmonary hypertension, [9] and pulmonary fibrosis [1] have been reported to be more prevalent in HIV-infected persons
Prior studies have been based largely on medical record review, and little is known about the prevalence of respiratory symptoms, degree of diagnostic testing related to cardiopulmonary disease, and prevalence and incidence of patient-reported diagnoses related to chronic lung disease in HIV-infected persons during the current highly active antiretroviral therapy (HAART) era
Summary
Several lung diseases are increasingly recognized as comorbidities with HIV; 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. Prior studies have been based largely on medical record review, and little is known about the prevalence of respiratory symptoms, degree of diagnostic testing related to cardiopulmonary disease, and prevalence and incidence of patient-reported diagnoses related to chronic lung disease in HIV-infected persons during the current HAART era.
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