Abstract
BackgroundChronic respiratory illnesses and respiratory infections are common in HIV-positive populations. It seems reasonable that HIV-positive people experience more respiratory symptoms, such as coughing and breathlessness, than those who are HIV-negative.ObjectivesThis study aims to determine the frequency of respiratory symptoms in an urban African HIV-positive population.MethodA cross-sectional study was conducted in Johannesburg, South Africa, in 2016–2017. Four groups of participants were included: HIV-positive participants (1) not yet on antiretroviral therapy (ART), (2) on first-line ART, (3) on second-line ART and (4) age- and sex-matched HIV-negative controls. Data were collected on socio-demographics, respiratory risk factors and respiratory symptoms. A logistic regression analysis was performed to determine if respiratory symptoms differed between groups and to identify determinants associated with symptoms.ResultsOverall, 547 participants were included, of whom 62% were women, with a median age of 37 years. Of these patients, 63% (347) were HIV-positive, 26% were ART-naïve, 24% were on first-line ART and 50% were on second-line ART. Cough and/or productive cough was reported by 27 (5%), wheezing by 9 (2%) and breathlessness by 118 (22%) of the participants. The frequency of these symptoms did not differ by HIV status after adjustment for age and sex. Breathlessness was associated with age, female sex, obesity, a history of respiratory infection and a history of airway hyper-reactivity.ConclusionThe frequency of respiratory symptoms was low in our study population except for breathlessness. HIV-positive participants, whether or not on ART, did not experience more symptoms than HIV-negative participants.
Highlights
In the last two decades, the introduction of antiretroviral therapy (ART) has substantially improved life expectancy of HIV-positive patients
Non-communicable chronic respiratory illnesses, such as chronic obstructive pulmonary disease (COPD), are more frequently seen in people living with HIV (PLHIV) compared to people without HIV.[3]
This is of interest when considering that PLHIV are ageing and respiratory symptoms are more frequent in an older population.[5]
Summary
In the last two decades, the introduction of antiretroviral therapy (ART) has substantially improved life expectancy of HIV-positive patients. Patients who are adequately treated with ART have a near-normal lifespan compared to the general population and, as a consequence, HIV has become a chronic disease.[1] One of the reasons for the increase in life expectancy in HIV-positive patients on ART is the lower frequency of severe and life-threatening opportunistic lung infections, such as tuberculosis and bacterial pneumonia.[2]. Non-communicable chronic respiratory illnesses, such as chronic obstructive pulmonary disease (COPD), are more frequently seen in people living with HIV (PLHIV) compared to people without HIV.[3] Studies have shown that PLHIV report more respiratory symptoms, such as coughing, productive cough and shortness of breath.[4] This is of interest when considering that PLHIV are ageing and respiratory symptoms are more frequent in an older population.[5]. It seems reasonable that HIV-positive people experience more respiratory symptoms, such as coughing and breathlessness, than those who are HIVnegative
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