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.
HIV Med
; 16 Suppl 1: 119-28, 2015 Apr.
Article
em En
| MEDLINE
| ID: mdl-25711330
ABSTRACT
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, naïve 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 sforced vital capacity (FEV1FVC) 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 FEV1FVC ratio (P < 0.0001). There was a significant effect of region on FEV1FVC ratio (P = 0.010).CONCLUSIONS:
Our data suggest that, among PLWH who were naïve to HIV treatment and had CD4 cell counts > 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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
Doença Pulmonar Obstrutiva Crônica
Tipo de estudo:
Clinical_trials
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Etiology_studies
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Observational_studies
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Prevalence_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
HIV Med
Assunto da revista:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Estados Unidos