title: COPD in HIV-Infected Patients: CD4 Cell Count Highly Correlated.
abstract: BACKGROUND
  COPD is a frequent and significant cause of respiratory morbidity in HIV-infected patients despite the control of HIV. We aimed to analyze the factors correlated with COPD in this population to evaluate the existence of specific indicators of vulnerability in this population.
  
  
  RESULTS
  623 HIV-infected outpatients were enrolled during one year. This population was characterised by a dedicated questionnaire and electronic patient records. COPD screening was performed according to recommended spirometric criteria. The prevalence of COPD was 9.0%. Age and smoking were independently correlated with COPD (OR, 1.61 per 10 years increase, P = 0.007; OR, 1.28 per 10 pack-year increase, P = 0.003, respectively). Body mass index (BMI) and CD4 cell-count were independently and negatively correlated with COPD (OR, 0.78, P < 0.001; 0R, 0.77 per 100 cell/mm3 increase, P < 0.001, respectively). Among COPD patients, 77% did not know their diagnosis. Five COPD-patients never smoked and 44.2% did not have any respiratory symptoms and so were not eligible to perform a spirometry according to the guidelines.
  
  
  CONCLUSIONS
  In addition to known risk factors, immune defect through CD4 cell count was independently and strongly correlated with COPD. COPD is largely underdiagnosed and thus unmanaged. However, early management and urgent smoking cessation are essential to improve prognosis. Clinicians' awareness on the particular vulnerability for COPD in HIV-infected patients is crucial. Moreover, indications to perform conventional spirometry to diagnose COPD may include more parameters than tobacco-smoking and respiratory complaints with a particular concern toward patients with a profound CD4 cell count defect.
authors.affiliation: Service d'Infectiologie, Centre Hospitalier Universitaire de Nice, Nice, France.|Université de Nice-Sophia-Antipolis, Nice, France.
authors.forename: Karine
authors.identifier: http://orcid.org/0000-0001-9715-197X
authors.initials: K
authors.lastname: Risso
authors.affiliation: Service d'Infectiologie, Centre Hospitalier Universitaire de Nice, Nice, France.
authors.forename: Francine
authors.initials: F
authors.lastname: Guillouet-de-Salvador
authors.affiliation: Département d'Informations Médicales, Centre Hospitalier de la Dracénie, Draguignan, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Valerio
authors.affiliation: Service d'Infectiologie, Centre Hospitalier Universitaire de Nice, Nice, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Puglièse
authors.affiliation: Service d'Infectiologie, Centre Hospitalier Universitaire de Nice, Nice, France.
authors.forename: Alissa
authors.initials: A
authors.lastname: Naqvi
authors.affiliation: Service d'Infectiologie, Centre Hospitalier Universitaire de Nice, Nice, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Durant
authors.affiliation: Service d'Infectiologie, Centre Hospitalier Universitaire de Nice, Nice, France.|Université de Nice-Sophia-Antipolis, Nice, France.
authors.forename: Elisa
authors.initials: E
authors.lastname: Demonchy
authors.affiliation: Service d'Infectiologie, Centre Hospitalier Universitaire de Nice, Nice, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Perbost
authors.affiliation: Service d'Infectiologie, Centre Hospitalier Universitaire de Nice, Nice, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Cua
authors.affiliation: Université de Nice-Sophia-Antipolis, Nice, France.|Service de Pneumologie, Centre Hospitalier Universitaire de Nice, Nice, France.
authors.forename: Charles-Hugo
authors.initials: CH
authors.lastname: Marquette
authors.affiliation: Service d'Infectiologie, Centre Hospitalier Universitaire de Nice, Nice, France.|Université de Nice-Sophia-Antipolis, Nice, France.
authors.forename: Pierre-Marie
authors.initials: PM
authors.lastname: Roger
mesh_terms: D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000276:immunology / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000276:immunology / Q000473:pathology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013147:Spirometry