Pulmonary function in an international sample of HIV-positive, treatment-naïve adults with CD4 counts > 500 cells/μL: a substudy of the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial
| Autor: | C Akolo, Ken M. Kunisaki, A. La Rosa, H Klinker, Gary Collins, Dennis E. Niewoehner, Cissy M Kityo, Ellen Tedaldi, John E. Connett, Daniel E. Nixon |
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| Rok vydání: | 2015 |
| Předmět: |
Spirometry
Vital capacity medicine.medical_specialty COPD medicine.diagnostic_test business.industry Health Policy medicine.disease Pulmonary function testing FEV1/FVC ratio Infectious Diseases Interquartile range Internal medicine Cohort Physical therapy Medicine Pharmacology (medical) business Viral load |
| Zdroj: | HIV Medicine. 16:119-128 |
| ISSN: | 1464-2662 |
| Popis: | Objectives The aim of the study was to describe the prevalence and correlates of chronic obstructive pulmonary disease (COPD) in a multicentre international cohort of persons living with HIV (PLWH). Methods We performed a cross-sectional analysis of adult PLWH, naive to HIV treatment, with baseline CD4 cell count > 500 cells/μL enrolled in the Pulmonary Substudy of the Strategic Timing of AntiRetroviral Treatment (START) trial. We collected standardized, quality-controlled spirometry. COPD was defined as forced expiratory volume in 1 s:forced vital capacity (FEV1:FVC) ratio less than the lower limit of normal. Results Among 1026 participants from 80 sites and 20 countries, the median age was 36 [interquartile range (IQR) 30, 44] years, 29% were female, and the median time since HIV diagnosis was 1.2 (IQR 0.4, 3.5) years. Baseline median CD4 cell count was 648 (IQR 583, 767) cells/μL, median viral load was 4.2 (IQR 3.5, 4.7) log10 HIV-1 RNA copies/mL, and 10% had a viral load ≤ 400 copies/mL despite lack of HIV treatment. Current/former/never smokers comprised 28%/11%/61% of the cohort, respectively. COPD was present in 6.8% of participants, and varied by age, smoking status and region. Forty-eight per cent of those with COPD reported lifelong nonsmoking. In multivariable regression, age and pack-years of smoking had the strongest associations with FEV1:FVC ratio (P 500 cells/μL, smoking and age were important factors related to COPD. Smoking cessation should remain a high global priority for clinical care and research in PLWH. |
| Databáze: | OpenAIRE |
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