Pulmonary symptoms and diagnoses are associated with HIV in the MACS and WIHS cohorts

BMC Pulmonary Medicine

Alison Morris⁷  Marnie Bertolet²  Sarah H Sutton⁸  Laurence Huang³  Susan Holman⁶  Ruth M Greenblatt⁴  Eric C Seaberg⁹  Roger Detels^1,10  Eric C Kleerup^1,10  Lawrence Kingsley⁵  Thomas B Rice¹  Goundappa K Balasubramani²  Matthew R Gingo¹ 

[1] Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA;Department of Epidemiology, Epidemiology Data Center, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA;Department of Medicine, School of Medicine, University of California, San Francisco, CA, USA;Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA, USA;Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA;Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, USA;Department of Immunology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA;Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA;Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA;Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA

关键词: Sleep apnea syndromes;    Respiratory tract diseases;    Chronic obstructive;    Pulmonary disease;    HIV;    AIDS;   

Others  :  862974
DOI  :  10.1186/1471-2466-14-75

 received in 2013-12-04, accepted in 2014-04-17,  发布年份 2014

【 摘 要 】

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.

【 授权许可】

   
2014 Gingo et al.; licensee BioMed Central Ltd.

【 图 表 】

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