title: Respiratory health status is impaired in UK HIV-positive adults with virologically suppressed HIV infection.
abstract: We sought to evaluate whether people living with HIV (PLWH) using effective antiretroviral therapy (ART) have worse respiratory health status than similar HIV-negative individuals.
  
  
  
  We recruited 197 HIV-positive and 93 HIV-negative adults from HIV and sexual health clinics. They completed a questionnaire regarding risk factors for respiratory illness. Respiratory health status was assessed using the St George's Respiratory Questionnaire (SGRQ) and the Medical Research Council (MRC) breathlessness scale. Subjects underwent spirometry without bronchodilation.
  
  
  
  PLWH had worse respiratory health status: the median SGRQ Total score was 12 [interquartile range (IQR) 6-25] in HIV-positive subjects vs. 6 (IQR 2-14) in HIV-negative subjects (P < 0.001); breathlessness was common in the HIV-positive group, where 47% compared with 24% had an MRC breathlessness score ≥ 2 (P = 0.001). Eighteen (11%) HIV-positive and seven (9%) HIV-negative participants had airflow obstruction. In multivariable analyses (adjusted for age, gender, smoking, body mass index and depression), HIV infection remained associated with higher SGRQ and MRC scores, with an adjusted fold-change in SGRQ Total score of 1.54 [95% confidence interval (CI) 1.14-2.09; P = 0.005] and adjusted odds ratio of having an MRC score of ≥ 2 of 2.45 (95% CI 1.15-5.20; P = 0.02). Similar findings were obtained when analyses were repeated including only HIV-positive participants with a viral load < 40 HIV-1 RNA copies/mL.
  
  
  
  Despite effective ART, impaired respiratory health appears more common in HIV-positive adults, and has a significant impact on health-related quality of life.
authors.affiliation: Department of Respiratory Medicine, Royal Free London NHS Foundation Trust, London, UK.|UCL Respiratory, Division of Medicine, University College London, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Brown
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK.
authors.forename: J A
authors.initials: JA
authors.lastname: McGowan
authors.affiliation: Departments of Sexual Health and HIV Medicine, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: H
authors.initials: H
authors.lastname: Chouial
authors.affiliation: Department of Respiratory Medicine, Royal Free London NHS Foundation Trust, London, UK.|UCL Respiratory, Division of Medicine, University College London, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Capocci
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK.
authors.forename: C
authors.initials: C
authors.lastname: Smith
authors.affiliation: Departments of Sexual Health and HIV Medicine, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: D
authors.initials: D
authors.lastname: Ivens
authors.affiliation: Departments of Sexual Health and HIV Medicine, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Johnson
authors.affiliation: Departments of Sexual Health and HIV Medicine, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: L
authors.initials: L
authors.lastname: Sathia
authors.affiliation: Departments of Sexual Health and HIV Medicine, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Shah
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK.
authors.forename: F C
authors.initials: FC
authors.lastname: Lampe
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK.|Departments of Sexual Health and HIV Medicine, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Rodger
authors.affiliation: Department of Respiratory Medicine, Royal Free London NHS Foundation Trust, London, UK.|UCL Respiratory, Division of Medicine, University College London, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Lipman
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012140:Respiratory Tract Diseases / Q000453:epidemiology* / Q000473:pathology*; D013147:Spirometry; D011795:Surveys and Questionnaires; D000072230:Sustained Virologic Response; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D044966:Anti-Retroviral Agents
keywords: lung; patient reported outcome; quality of life; respiratory; smoking