here your doctor

Patients infected with HIV appear to be at increased risk of developing chronic obstructive pulmonary disease (COPD) compared to uninfected people may show the results of a study published in "Chest".

If smoking is a major risk factor for COPD, there are others as nonsmokers also develop this respiratory disease, recall Dr. Kristina Crothers, of the Yale School of Medicine in New Haven, and colleagues.

HIV + patients seem to constitute a population with increased susceptibility to COPD, previous studies have demonstrated in patients with bronchial hyperreactivity or emphysema. Since smoking appears prevalent among HIV + patients, U.S. researchers conducted a study to determine the potential role of HIV infection in the development of COPD.

To do this, they analyzed data from a prospective study, the Veterans aging cohort study site 5 (VACS 5), conducted among 1,031 HIV + patients and 740 HIV-controls, recruited between 2001 and 2002 in five centers in the U.S. office Veterans Affairs. After exclusion of women and known smoking, the study included 1,014 HIV + patients and 713 controls.

The prevalence of COPD has reached respectively 10% and 9% in both groups, with no significant difference. But the researchers, noting that the International Classification of Diseases ICD-9 (International classification of diseases) used to obtain this result is less sensitive than all the notes collected by caregivers for diagnosis, also asked participants if a doctor had already spoken with chronic respiratory disease (emphysema, asthma, chronic bronchitis or COPD) them. The prevalence was then raised to 15% and 12%, a significant difference.

CD4 count, viral load, or highly active antiretroviral therapy (HAART) followed were comparable in HIV + patients with COPD and those not suffering from the lung disease.

After adjustment to take into account the influence of age, ethnicity, smoking (in pack-years), consumption of drugs or alcohol abuse, data analysis indicates that the Infection with HIV is an independent risk factor for COPD. Thus, compared to non-HIV-infected people, HIV-positive participants appeared at increased risk of 47% (for a diagnosis made with the classification ICD-9) and 60% (based on reports of patients) risk.

These results suggest that HIV infection increased from 50 to 60% risk of COPD, the researchers concluded, noting that younger age and less smoking (in terms of pack-years) in HIV + patients compared to the control group may explain the similar prevalence of COPD in both groups.

It remains to prove that there is a causal link between HIV infection and COPD and to elucidate the mechanism by which HIV infection increases the risk of COPD, which requires further study and vigilance on caregivers risk in HIV + patients, the authors write.