Researchers suggest COPD screening in certain patients with HIV
Click Here to Manage Email Alerts
People with HIV had a higher rate of COPD incidence and were diagnosed at a younger age than those without HIV, according to research published in CMAJ Open.
“Because women and men with HIV were found to have higher rates of COPD than the general population, and COPD was diagnosed at an earlier age, testing for COPD should be considered in patients with HIV with chronic respiratory symptoms and a history of smoking,” Tony Antoniou, PhD, a scientist at the Li Ka Shing Knowledge Institute of St. Michael's Hospital and the University of Toronto, Canada, told Healio Primary Care. “In addition, supporting patients to quit smoking should become an increasing priority where possible.”
Antoniou and colleagues used multiple Ontario health administrative databases to conduct the population-based study. They identified people aged 35 years and older with (n = 1,849) and without HIV (n = 1,168,727) in Ontario who were newly diagnosed with COPD between 1996 and 2015.
Participants with HIV were approximately 12 years younger at COPD diagnosis than those without HIV, with a mean age of 49.7 years in those with HIV and 62.2 years in those without HIV, according to the researchers.
Antoniou and colleagues also identified a higher incidence of COPD among those with HIV, with 10.9 cases per 1,000 person-years, compared with nine cases per 1,000 person-years among those without HIV (standardized incidence ratio = 1.16; 95% CI, 1.1-1.21; adjusted rate ratio = 1.34; 95% CI, 1.27-1.41).
Further analyses stratified by gender revealed the rate of COPD was higher among both men with HIV (adjusted rate ratio = 1.32; 95% CI, 1.24-1.4) and women with HIV (adjusted rate ratio = 1.54; 95% CI, 1.37-1.72) compared with their HIV-negative counterparts.
In a sensitivity analysis that used conservative estimates of COPD risk among smokers and smoking prevalence among Ontario residents, researchers found that people with HIV no longer had an elevated risk for COPD compared with those who did not have HIV.
“Primary care physicians should tell patients with HIV that while other factors may influence the risk of developing COPD, smoking is a modifiable risk factor that is most strongly associated with developing this illness,” Antoniou said.
“Because COPD is not curable (though it can be managed with medication), may occur at younger ages in people with HIV and can reduce quality of life, patients should report symptoms such as shortness of breath and nagging coughs that won’t go away to ensure that testing for COPD can be undertaken if clinically appropriate,” he explained. – by Erin Michael
Disclosures: The authors report no relevant financial disclosures.