Objectives: We aimed to evaluate the prevalence of chronic respiratory symptoms and to perform a screening for Chronic Obstructive Pulmonary Disease (COPD) in a cohort of HIV-infected patients. Methods: The COPS study is a prospective, observational, multicentre study. Screening for COPD was performed using the 5- item GOLD questionnaire. Patients with ≥3 positive answers were considered as probable COPD (pCOPD). Results: A total of 687 HIV-infected patients with a mean age of 47.7 ± 9.9 years were enrolled, of these 513 (74.7%) were male, 639 (93.0%) Caucasians and 158 (23.4%) were previous intravenous drug-users (IDU). Mean CD4 cell count was 679 ± 348 cells/mm3, HIV-RNA was undetectable in 511 (75.9%) and 39 (5.7%) were naive. In 192 (28.1%) patients a chronic hepatitis was also present. Regarding respiratory symptoms 131 (19.1%) reported chronic cough, 148 (21.5%) sputum and 140 (20.4%) dyspnoea. Furthermore, 558 (81.3%) were older than 40 years old and 500 (72.9%) where current/previous smokers. According to the GOLD questionnaire, 215 (31.2%) patients were considered as pCOPD. At univariate analysis, patients with pCOPD were significantly older (p< 0.0001) and more frequently current/previous smokers (p< 0.0001), previous IDU (p=0.0006), had a current/past alcohol abuse (p< 0.0001), a history of pulmonary infection (p< 0.0001), a chronic hepatitis (p< 0.0001) and were less frequently naive to antiretrovirals (p=0.009). At multivariate analysis, pCOPD was associated with older age (OR 1.16, CI 1.048-1.285), previous (OR 2.77, CI 1.442-5.321) or current smoking (OR 9.80, CI 5.45-17.64), previous pulmonary infection (OR 1.86, CI 1.21-2.86), naive status (OR 0.32, CI 0.12-0.87) and chronic hepatitis (OR 1.52, CI 1.02-2.27). Conclusion: Our data show a high prevalence of chronic respiratory symptoms and pCOPD in a HIV-infected outpatient population. Smoking cessation and early cART initiation could represent a comprehensive strategy to reduce the burden of COPD in the HIV-infected population.

Prevalence of Respiratory Symptoms and Screening for Chronic Obstructive Pulmonary Disease: Results from an Italian Multicenter Study / Fois AG; Bagella P; Ricci E; Farenga M; Martinelli C; De Socio GV; Bellacosa C; Celesia BM; Menzaghi B; Franzetti M; Bonfanti P; Madeddu G. - (2015). ((Intervento presentato al convegno 15th European AIDS Conference tenutosi a Barcellona nel 21-24 October 2015.

Prevalence of Respiratory Symptoms and Screening for Chronic Obstructive Pulmonary Disease: Results from an Italian Multicenter Study

MADEDDU, Giordano
2015

Abstract

Objectives: We aimed to evaluate the prevalence of chronic respiratory symptoms and to perform a screening for Chronic Obstructive Pulmonary Disease (COPD) in a cohort of HIV-infected patients. Methods: The COPS study is a prospective, observational, multicentre study. Screening for COPD was performed using the 5- item GOLD questionnaire. Patients with ≥3 positive answers were considered as probable COPD (pCOPD). Results: A total of 687 HIV-infected patients with a mean age of 47.7 ± 9.9 years were enrolled, of these 513 (74.7%) were male, 639 (93.0%) Caucasians and 158 (23.4%) were previous intravenous drug-users (IDU). Mean CD4 cell count was 679 ± 348 cells/mm3, HIV-RNA was undetectable in 511 (75.9%) and 39 (5.7%) were naive. In 192 (28.1%) patients a chronic hepatitis was also present. Regarding respiratory symptoms 131 (19.1%) reported chronic cough, 148 (21.5%) sputum and 140 (20.4%) dyspnoea. Furthermore, 558 (81.3%) were older than 40 years old and 500 (72.9%) where current/previous smokers. According to the GOLD questionnaire, 215 (31.2%) patients were considered as pCOPD. At univariate analysis, patients with pCOPD were significantly older (p< 0.0001) and more frequently current/previous smokers (p< 0.0001), previous IDU (p=0.0006), had a current/past alcohol abuse (p< 0.0001), a history of pulmonary infection (p< 0.0001), a chronic hepatitis (p< 0.0001) and were less frequently naive to antiretrovirals (p=0.009). At multivariate analysis, pCOPD was associated with older age (OR 1.16, CI 1.048-1.285), previous (OR 2.77, CI 1.442-5.321) or current smoking (OR 9.80, CI 5.45-17.64), previous pulmonary infection (OR 1.86, CI 1.21-2.86), naive status (OR 0.32, CI 0.12-0.87) and chronic hepatitis (OR 1.52, CI 1.02-2.27). Conclusion: Our data show a high prevalence of chronic respiratory symptoms and pCOPD in a HIV-infected outpatient population. Smoking cessation and early cART initiation could represent a comprehensive strategy to reduce the burden of COPD in the HIV-infected population.
Prevalence of Respiratory Symptoms and Screening for Chronic Obstructive Pulmonary Disease: Results from an Italian Multicenter Study / Fois AG; Bagella P; Ricci E; Farenga M; Martinelli C; De Socio GV; Bellacosa C; Celesia BM; Menzaghi B; Franzetti M; Bonfanti P; Madeddu G. - (2015). ((Intervento presentato al convegno 15th European AIDS Conference tenutosi a Barcellona nel 21-24 October 2015.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11388/54084
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