Screening for Chronic Obstructive Pulmonary Disease (COPD) in an Urban HIV Clinic: A Pilot Study

AIDS Patient Care and STDs
Daniel K ShirleyMarshall J Glesby

Abstract

Increased smoking and a detrimental response to tobacco smoke in the lungs of HIV/AIDS patients result in an increased risk for COPD. We aimed to determine the predictive value of a COPD screening strategy validated in the general population and to identify HIV-related factors associated with decreased lung function. Subjects at least 35 years of age at an HIV clinic in New York City completed a COPD screening questionnaire and peak flow measurement. Those with abnormal results and a random one-third of normal screens had spirometry. 235 individuals were included and 89 completed spirometry. Eleven (12%) had undiagnosed airway obstruction and 5 had COPD. A combination of a positive questionnaire and abnormal peak flow yielded a sensitivity of 20% (specificity 93%) for detection of COPD. Peak flow alone had a sensitivity of 80% (specificity 80%). Abnormal peak flow was associated with an AIDS diagnosis (p=0.04), lower nadir (p=0.001), and current CD4 counts (p=0.001). Nadir CD4 remained associated in multivariate analysis (p=0.05). Decreased FEV1 (<80% predicted) was associated with lower CD4 count nadir (p=0.04) and detectable current HIV viral load (p=0.01) in multivariate analysis. Questionnaire and peak flow together had low...Continue Reading

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Citations

Nov 12, 2015·Current Opinion in Infectious Diseases·Paul Collini, Alison Morris
Apr 21, 2016·COPD·Allison A LambertGregory D Kirk
Jan 6, 2017·PloS One·Karine RissoPierre-Marie Roger
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Apr 15, 2020·AIDS·Ken M KunisakiAlison Morris
Nov 11, 2020·Expert Review of Respiratory Medicine·Katerina ByanovaLaurence Huang
Jul 10, 2021·AIDS Patient Care and STDs·Kristin R V HarringtonSara C Auld
Jul 30, 2021·Journal of Family Medicine and Primary Care·Jyoti TyagiSoumyadeep Bhaumik
Dec 9, 2021·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Engi F AttiaSarah F Benki-Nugent

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