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BMC Pulmonary Medicine
Published in: BMC Pulmonary Medicine 1/2014

Open Access 01-12-2014 | Research article

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

Authors: Matthew R Gingo, Goundappa K Balasubramani, Thomas B Rice, Lawrence Kingsley, Eric C Kleerup, Roger Detels, Eric C Seaberg, Ruth M Greenblatt, Susan Holman, Laurence Huang, Sarah H Sutton, Marnie Bertolet, Alison Morris

Published in: BMC Pulmonary Medicine | Issue 1/2014

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Abstract

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.
Appendix
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Metadata
Title
Pulmonary symptoms and diagnoses are associated with HIV in the MACS and WIHS cohorts
Authors
Matthew R Gingo
Goundappa K Balasubramani
Thomas B Rice
Lawrence Kingsley
Eric C Kleerup
Roger Detels
Eric C Seaberg
Ruth M Greenblatt
Susan Holman
Laurence Huang
Sarah H Sutton
Marnie Bertolet
Alison Morris
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2014
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/1471-2466-14-75

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