Journal Article

Chronic obstructive pulmonary disease prevalence and associated factors in an urban HIV clinic in a low income country

Ddungu, Ahmed, Sekaggya-Wiltshire, Christine, Worodria, William, Castelnuovo, Barbara, Kirenga, Bruce J., Semitala, Fred C.

2021

Overview

In the last decade, survival of people living with HIV (PLHIV) has dramatically increased due wide availability of effective antiretroviral therapy. However, PLHIV remain at a comparatively higher risk of non-communicable comorbidities. We sought to determine the burden of COPD and its associations in an urban tertiary HIV clinic in Uganda. HIV-infected adults attending the Makerere University Joint AIDS program; aged ≥30 years without acute ailments were screened for COPD using study questionnaires and spirometry (post-bronchodilator FEV1/FVC<0.7). We determined its prevalence and association with demographic characteristics, body mass index (BMI) and known risk factors. Of 288 participants enrolled, 177 (61%) were female; 253 (88%) were from urban residences, median age was 45 years (IQR: 39-51), 71(25%) were 'ever' smokers, 284(99%) reported biomass fuel use and 72(25%) had a history of tuberculosis. All except 1 participant were on antiretroviral therapy, median current CD4 (cells/mm3) was 558 (IQR 402-753) and 275(96%) were virologically suppressed. Nearly half (130/288, 45%) had recurrent respiratory symptoms. The prevalence of COPD was 3.1% (9/288) [95% CI: 1.63-5.92]. COPD was associated with: previous tuberculosis, (adjusted odds ratio (AOR): 6.36, [95% CI 1.64-35.84], P = 0.036), self-reported chronic shortness of breath (AOR: 9.06, [95% CI 1.34-61.10], P = 0.024) and a BMI <21 Kg/m2 (AOR: 10.42 [95% CI: 1.61-100.00], P = 0.013). In this HIV population, COPD prevalence was low and was associated with previous tuberculosis, self-reported chronic shortness of breath and BMI <21 Kg/m2.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Acquired immune deficiency syndrome / Adult / AIDS / Antiretroviral agents / Antiretroviral drugs / Antiretroviral therapy / Biology and Life Sciences / Biomass energy / Body mass / Body mass index / Body size / Bronchodilators / CD4 antigen / Chronic obstructive pulmonary disease / Comorbidity / Complications and side effects / Cross-Sectional Studies / Demographic aspects / Drug therapy / Dyspnea / Evaluation / Female / Health sciences / HIV / HIV infection / HIV Infections - complications / HIV Infections - drug therapy / HIV Infections - virology / HIV-1 - physiology / Hospitals / Human immunodeficiency virus / Humans / Infectious diseases / Low income areas / Low income groups / Lung diseases / Lung diseases, Obstructive / Male / Medical diagnosis / Medicine and Health Sciences / Middle Aged / Obstructive lung disease / Patients / People and Places / Poverty - statistics & numerical data / Prevalence studies (Epidemiology) / Pulmonary Disease, Chronic Obstructive - diagnosis / Pulmonary Disease, Chronic Obstructive - epidemiology / Pulmonary Disease, Chronic Obstructive - etiology / Research and Analysis Methods / Risk analysis / Risk Factors / Signs and symptoms / Smoking - adverse effects / Spirometry / Spirometry - methods / Supervision / Surveys and Questionnaires / Systematic review / Tuberculosis / Uganda - epidemiology