COPD screening needed in HIV-positive patients

Many HIV-positive patients who meet the criteria for COPD are not receiving proper treatment.
Many HIV-positive patients who meet the criteria for COPD are not receiving proper treatment.

Patients with HIV have an increased risk for developing chronic obstructive pulmonary disease (COPD), according to research published in AIDS Care.

Bahareh Ghadaki, MD, of the Department of Infectious Disease and Medical Microbiology at Michael G. DeGroote School of Medicine, McMaster University, in Hamilton, Ontario, and colleagues conducted a study of 247 HIV-positive patients to determine the effects of smoking on patients' respiratory symptoms and diseases.

Participants completed a self-administered questionnaire, and the COPD screening criteria were adapted from the Canadian Thoracic Society (CTS) guidelines. Of the participants, 92% were undergoing therapy with highly active antiretroviral therapy, and 66% of the participants were smokers. The researchers found that smoking had a statistically significant effect on wheezing, phlegm production, cough, and dyspnea; participants also had a higher likelihood of developing respiratory diseases such as COPD or bronchitis.

“Among HIV-positive smokers, 40% met the CTS screening criteria [for COPD], while only 12% self-reported a diagnosis of COPD,” Dr Ghadaki stated. “The burden of smoking in the HIV population is significant. HIV-positive smokers are more likely to report both respiratory symptoms and diseases.

“A discrepancy exists between patients who met the CTS screening criteria and those who were diagnosed with COPD, raising the concern for under-recognition and under-diagnosis of COPD in this population,” concluded Dr Ghadaki.

Reference

  1. Ghadaki B, Kronfli N, Vanniyasingam T, Haider S. Chronic obstructive pulmonary disease and HIV: are we appropriately screening? AIDS Care. 2016;30:1-6; doi: 10.1080/09540121.2016.118499
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