Research bronchoscopies do not adversely affect HIV-infected individuals' future health-care decisions.
OBJECTIVE
Asymptomatic HIV-infected individuals are increasingly recruited for studies involving invasive procedures such as bronchoscopy. We sought to determine the response to and outcome of a request for a research bronchoscopy in HIV-positive individuals with no respiratory disease, and whether this would adversely affect future decisions to have a medically indicated bronchoscopy.


METHODS
Prospective, semistructured, questionnaire-based study in a London teaching hospital HIV outpatient clinic.


METHODS
One hundred and seven consecutive HIV-infected eligible individuals. Thirty-one healthy volunteers served as a control group for the subjective response to bronchoscopy.


METHODS
Subjects' attitudes and responses to requests for bronchoscopy and subsequent behavior when they required medically indicated bronchoscopy.


RESULTS
Seventy-five patients (70%) agreed to the procedure in principle, predominantly for altruistic reasons. Thirty-nine subjects underwent bronchoscopy. Five percent found it worse than expected; and 79% agreed to another research bronchoscopy (performed in 11 subjects approximately 2 years later). All patients said they would undergo bronchoscopy again for diagnostic purposes (required in seven during the study). When compared to a healthy volunteer population within the same study, postbronchoscopy symptoms were similar in frequency although somewhat different in nature. Subjects felt that a clear explanation of what was involved enhanced their participation in this research.


CONCLUSIONS
Invasive research procedures such as bronchoscopy can be performed and are repeatable in a healthy HIV-infected population. Performance of procedures for research purposes does not appear to adversely affect future health-care decisions.
Lipman
M C
MC
Department of Thoracic Medicine, Royal Free Hospital, London, UK.
Stobbs
D
D
Madge
S
S
Miller
R
R
Johnson
M A
MA
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000533:Altruism; D001294:Attitude to Health; D018893:Bronchoalveolar Lavage / Q000009:adverse effects / Q000523:psychology; D001999:Bronchoscopy / Q000009:adverse effects / Q000523:psychology*; D018791:CD4 Lymphocyte Count; D016009:Chi-Square Distribution; D003142:Communication; D003657:Decision Making; D005260:Female; D005544:Forecasting; D015658:HIV Infections / Q000523:psychology*; D006679:HIV Seropositivity / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D011446:Prospective Studies; D012106:Research; D011795:Surveys and Questionnaires; D001613:beta 2-Microglobulin / Q000032:analysis
D001613:beta 2-Microglobulin