Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital General, Departamento de Neumología, Ciudad de México, México.
Instituto de Seguridad y Servicios Social de los Trabajadores del Estado, Hospital Regional de Alta Especialidad "Centenario de la Revolución Mexicana, Ciudad de México, México.
Gac Med Mex. 2020;156(4):286-293. doi: 10.24875/GMM.20000110.
Chronic obstructive pulmonary disease (COPD) is the most prevalent respiratory problem in the world. Patients with human immunodeficiency virus (HIV) infection have a higher prevalence of smoking and recurrent lung infections and are at higher risk of COPD.
To determine the prevalence of COPD in HIV-diagnosed patients referred to an infectious diseases hospital.
Individuals with HIV infection without previous or ongoing antiretroviral treatment, with chronic respiratory symptoms, with or without a history of exposure for the development of COPD were included. Pre- and post-bronchodilation spirometry, high-resolution computed tomography, viral load determination and CD4 count were carried out. Spirometry measurements were compared with Wilcoxon's test.
Sixty-six HIV-diagnosed patients, with a mean age of 31.5 years were included; 64 were males and two females. The prevalence of COPD was 7.6 %. The group with obstruction had a lower CD4 count (27.3 versus 225.9) and higher viral load (165,000 versus 57,722), in comparison with the group without obstruction. A positive correlation was observed between lower viral load and higher forced expiratory volume in 1 second/forced vital capacity ratio.
HIV-positive patients with a lower CD4 count and a higher viral load show a decrease in spirometry values.
慢性阻塞性肺疾病（COPD）是世界上最常见的呼吸系统问题。感染人类免疫缺陷病毒（HIV）的患者吸烟和反复肺部感染的患病率较高，患 COPD 的风险也更高。
确定就诊于传染病医院的 HIV 诊断患者中 COPD 的患病率。
纳入无既往或正在进行的抗逆转录病毒治疗、有慢性呼吸道症状、有或无 COPD 发病暴露史的 HIV 感染个体。进行支气管扩张前和后肺量测定、高分辨率计算机断层扫描、病毒载量测定和 CD4 计数。对肺量测定测量值进行了 Wilcoxon 检验比较。
纳入了 66 例 HIV 诊断患者，平均年龄为 31.5 岁；其中 64 例为男性，2 例为女性。COPD 的患病率为 7.6%。与无阻塞组相比，阻塞组的 CD4 计数较低（273 与 2259 ），病毒载量较高（165000 与 57722 ）。较低的病毒载量与较高的 1 秒用力呼气量/用力肺活量比值呈正相关。
CD4 计数较低和病毒载量较高的 HIV 阳性患者的肺量测定值下降。
