Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Sassari, Via De Nicola 1, 07100, Sassari, Italy.
Infection. 2013 Apr;41(2):347-53. doi: 10.1007/s15010-012-0330-x. Epub 2012 Sep 13.
The objective of our study was to evaluate the presence of respiratory symptoms and chronic obstructive pulmonary disease (COPD) in a human immunodeficiency virus (HIV)-infected outpatient population and to further investigate the role of highly active antiretroviral therapy (HAART) and other possibly associated risk factors.
We consecutively enrolled in a cross-sectional study HIV-infected patients and HIV-negative age, sex and smoking status matched controls. All participants completed a questionnaire for pulmonary symptoms and underwent a complete spirometry.
We enrolled 111 HIV-infected patients and 65 HIV-negative age- and sex-matched controls. HIV-infected patients had a significantly higher prevalence of any respiratory symptom (p = 0.002), cough (p = 0.006) and dyspnoea (p = 0.02). HIV-infected patients also had a significantly higher prevalence of COPD in respect of HIV-negative controls (p = 0.008). Furthermore, HIV-infected individuals had significantly (p = 0.002) lower forced expiratory volume at one second (FEV1) and FEV1/forced vital capacity (FVC) ratio (Tiffeneau index) (p = 0.028), whereas the total lung capacity (TLC) was significantly higher (p = 0.018). In the multivariate analysis, significant predictors of respiratory symptoms were current smoking [adjusted odds ratio (AOR) 11.18; 95 % confidence interval (CI) 3.89-32.12] and previous bacterial pneumonia (AOR 4.41; 95 % CI 1.13-17.13), whereas the only significant predictor of COPD was current smoking (AOR 5.94; 95 % CI 1.77-19.96). HAART receipt was not associated with respiratory symptoms nor with COPD.
We evidenced a high prevalence of respiratory symptoms and COPD among HIV-infected patients. HIV infection, current cigarette smoking and previous bacterial pneumonia seem to play a significant role in the development of respiratory symptoms and COPD. Thus, our results suggest that the most at-risk HIV-infected patients should be screened for COPD to early identify those who may need specific treatment.
我们的研究旨在评估人类免疫缺陷病毒（HIV）感染门诊患者的呼吸症状和慢性阻塞性肺疾病（COPD）的存在，并进一步研究高效抗逆转录病毒治疗（HAART）和其他可能相关的危险因素的作用。
我们连续纳入了一项横断面研究中的 HIV 感染患者和 HIV 阴性、年龄、性别和吸烟状况匹配的对照组。所有参与者都完成了一份肺部症状问卷，并接受了完整的肺活量测定。
我们纳入了 111 名 HIV 感染患者和 65 名 HIV 阴性、年龄和性别匹配的对照组。HIV 感染患者的任何呼吸症状（p = 0.002）、咳嗽（p = 0.006）和呼吸困难（p = 0.02）的患病率均显著更高。与 HIV 阴性对照组相比，HIV 感染患者的 COPD 患病率也显著更高（p = 0.008）。此外，HIV 感染个体的用力呼气量第一秒（FEV1）和 FEV1/用力肺活量（FVC）比值（Tiffeneau 指数）显著降低（p = 0.002）（p = 0.028），而总肺活量（TLC）显著升高（p = 0.018）。在多变量分析中，呼吸症状的显著预测因素是当前吸烟[调整优势比（AOR）11.18；95%置信区间（CI）3.89-32.12]和既往细菌性肺炎（AOR 4.41；95%CI 1.13-17.13），而 COPD 的唯一显著预测因素是当前吸烟（AOR 5.94；95%CI 1.77-19.96）。HAART 接受与呼吸症状或 COPD 无关。
我们发现 HIV 感染患者呼吸症状和 COPD 的患病率较高。HIV 感染、当前吸烟和既往细菌性肺炎似乎在呼吸症状和 COPD 的发生中起重要作用。因此，我们的结果表明，最易受感染的 HIV 感染患者应进行 COPD 筛查，以早期识别可能需要特定治疗的患者。
