title: Prevalence of obstructive lung disease in HIV population: a cross sectional study.
abstract: BACKGROUND
  Observational studies have suggested an association between HIV infection and emphysema.
  
  
  OBJECTIVE
  The primary aim of this study was to estimate the prevalence of obstructive lung disease in HIV-infected patients seen in an outpatient infectious disease clinic. The secondary aim was to estimate the prevalence of Obstructive Lung Disease (OLD) in smokers and non smokers in this population.
  
  
  METHODS
  This was a prospective cross-sectional study. Consecutive patients who were seen for routine HIV care underwent spirometry and answered the St. George's Respiratory Questionnaire (SGRQ). Further, we collected information from the charts on demographics, co-morbidities, CD4 cell count, and HIV viral load (current, baseline, etc).
  
  
  RESULTS
  This study included 98 HIV-infected patients with mean age of 45 years, (SD: 11) and 84% male. They were seen from November 2008 to May 2009 at Thomas Jefferson University in Philadelphia. According to established criteria, spirometry results were classified as normal in 69% and obstructive in 16.3%. Among those who never smoked, the prevalence of obstructive lung disease on spirometry was 13.6%. The prevalence of obstruction in HIV patients with a history of smoking was 18.5%. Current and ever smokers comprised 21.4% and 55% of the patients respectively. The mean SGRQ total score was 7. The mean SGRQ score in active smokers was 17 and 15 in those subjects with a prior history of smoking. The mean SGRQ score among patients with obstruction in spiromerty was 27.7 in patients with obstruction on spirometry.
  
  
  CONCLUSIONS
  This urban population of HIV-infected persons has a relatively high prevalence of obstructive lung disease as assessed by spirometry. Furthermore, the high prevalence of obstructive lung disease in never smokers may suggest a possible association between HIV infection and emphysema. In addition the SGRQ total score was comparatively higher in patients with obstruction on spirometry. Our data suggests that potentially all patients with HIV should be screened a for OLD.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Thomas Jefferson University, Philadelphia, PA, USA. amyn.hirani@wellstar.org
authors.forename: Amyn
authors.initials: A
authors.lastname: Hirani
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Cavallazzi
authors.forename: Tajender
authors.initials: T
authors.lastname: Vasu
authors.forename: Monvasi
authors.initials: M
authors.lastname: Pachinburavan
authors.forename: Walter K
authors.initials: WK
authors.lastname: Kraft
authors.forename: Benjamin
authors.initials: B
authors.lastname: Leiby
authors.forename: William
authors.initials: W
authors.lastname: Short
authors.forename: Joseph
authors.initials: J
authors.lastname: Desimone
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Squires
authors.forename: Sandra
authors.initials: S
authors.lastname: Weibel
authors.forename: Gregory C
authors.initials: GC
authors.lastname: Kane
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015143:Philadelphia / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013147:Spirometry; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult