title: Factors associated with abnormal spirometry among HIV-infected individuals.
abstract: OBJECTIVE
  HIV-infected individuals are susceptible to development of chronic lung diseases, but little is known regarding the prevalence and risk factors associated with different spirometric abnormalities in this population. We sought to determine the prevalence, risk factors and performance characteristics of risk factors for spirometric abnormalities among HIV-infected individuals.
  
  
  METHODS
  Cross-sectional cohort study.
  
  
  METHODS
  We analyzed cross-sectional US data from the NHLBI-funded Lung-HIV consortium - a multicenter observational study of heterogeneous groups of HIV-infected participants in diverse geographic sites. Logistic regression analysis was performed to determine factors statistically significantly associated with spirometry patterns.
  
  
  RESULTS
  A total of 908 HIV-infected individuals were included. The median age of the cohort was 50 years, 78% were men and 68% current smokers. An abnormal spirometry pattern was present in 37% of the cohort: 27% had obstructed and 10% had restricted spirometry patterns. Overall, age, smoking status and intensity, history of Pneumocystis infection, asthma diagnosis and presence of respiratory symptoms were independently associated with an abnormal spirometry pattern. Regardless of the presence of respiratory symptoms, five HIV-infected participants would need to be screened with spirometry to diagnose two individuals with any abnormal spirometry pattern.
  
  
  CONCLUSIONS
  Nearly 40% of a diverse US cohort of HIV-infected individuals had an abnormal spirometry pattern. Specific characteristics including age, smoking status, respiratory infection history and respiratory symptoms can identify those at risk for abnormal spirometry. The high prevalence of abnormal spirometry and the poor predictive capability of respiratory symptoms to identify abnormal spirometry should prompt clinicians to consider screening spirometry in HIV-infected populations.
authors.affiliation: aDepartment of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland bDepartment of Medicine, School of Medicine, University of California San Francisco, San Francisco, California cDepartment of Medicine, Ohio State University, Columbus, Ohio dDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland eDepartment of Medicine, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California fDepartments of Medicine and Immunology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania gDivision of Pulmonary & Critical Care Medicine, Departments of Medicine and Environmental Medicine, New York University School of Medicine, New York hClinical Trials and Survey Corporation, Owings Mills, Maryland iDepartment of Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: M Bradley
authors.initials: MB
authors.lastname: Drummond
authors.forename: Laurence
authors.initials: L
authors.lastname: Huang
authors.forename: Philip T
authors.initials: PT
authors.lastname: Diaz
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Kirk
authors.forename: Eric C
authors.initials: EC
authors.lastname: Kleerup
authors.forename: Alison
authors.initials: A
authors.lastname: Morris
authors.forename: William
authors.initials: W
authors.lastname: Rom
authors.forename: Michael D
authors.initials: MD
authors.lastname: Weiden
authors.forename: Enxu
authors.initials: E
authors.lastname: Zhao
authors.forename: Bruce
authors.initials: B
authors.lastname: Thompson
authors.forename: Kristina
authors.initials: K
authors.lastname: Crothers
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008171:Lung Diseases / Q000453:epidemiology* / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D013147:Spirometry; D014481:United States / Q000453:epidemiology