title: HIV Associated Chronic Obstructive Pulmonary Disease in Nigeria.
abstract: OBJECTIVE
  To determine the prevalence and risk factors for chronic obstructive pulmonary disease (COPD) among HIV-infected adults in Nigeria.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  HIV-infected adults aged ≥ 30 years with no acute ailments accessing care at the antiretroviral therapy clinic of Jos University Teaching Hospital were enrolled consecutively. Participants were interviewed to obtain pertinent demographic and clinical information, including exposure to risk factors for COPD. Post-bronchodilator spirometry was carried out. HIV related information was retrieved from the clinic medical records. COPD case-definition was based on the Global Initiative for Obstructive Lung Disease (GOLD) criteria using post-bronchodilator FEV1/FVC <0.7. COPD prevalence was also calculated using the lower limit of normal for FEV1/FVC criteria (LLN) from the European Respiratory Society normative equation. Factors associated with COPD were determined using logistic regression models.
  
  
  RESULTS
  Study population comprised 356 HIV infected adults with mean age of 44.5 (standard deviation, 7.1) years and 59% were female. The mean time elapsed since HIV diagnosis was 7.0 (SD, 2.6) years and 97.5% of the respondents were on stable ART with virologic suppression present in 67.2%. Prevalence of COPD were 15.4% (95% confidence interval [CI] 11.7-19.2), 12.07% (95% CI 8.67-15.48), 22.19% (95% CI 18.16-26.83) using GOLD, ERS LLN and GLI LLN diagnostic criteria respectively. In multivariate analyses adjusting for gender, exposure to cigarette smoke or biomass, history of pulmonary tuberculosis, use of antiretroviral therapy, current CD4 T-cell count and HIV RNA, only age > 50 years was independently associated with COPD with OR 3.4; 95% CI 1.42-8.17 when compared to ages 30-40 years.
  
  
  CONCLUSIONS
  HIV-associated COPD is common in our population of HIV patients.
authors.affiliation: Department of Medicine, Jos University Teaching Hospital, Jos, Nigeria.
authors.forename: Maxwell O
authors.initials: MO
authors.lastname: Akanbi
authors.affiliation: Northwestern University Chicago, USA.
authors.forename: Babafemi O
authors.initials: BO
authors.lastname: Taiwo
authors.affiliation: Northwestern University Chicago, USA.
authors.forename: Chad J
authors.initials: CJ
authors.lastname: Achenbach
authors.affiliation: Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria.
authors.forename: Obianuju B
authors.initials: OB
authors.lastname: Ozoh
authors.affiliation: Department of Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria.
authors.forename: Daniel O
authors.initials: DO
authors.lastname: Obaseki
authors.affiliation: Department of Family Medicine, Jos University Teaching Hospital, Nigeria.
authors.forename: Halima
authors.initials: H
authors.lastname: Sule
authors.affiliation: Department of Medicine, Jos University Teaching Hospital, Jos, Nigeria.
authors.forename: Oche O
authors.initials: OO
authors.lastname: Agbaji
authors.affiliation: Department of Medicine, Jos University Teaching Hospital, Jos, Nigeria.
authors.forename: Christiana O
authors.initials: CO
authors.lastname: Ukoli
keywords: Africa; COPD; HIV; Lung disease; Nigeria; Spirometry