Increased COPD among HIV-positive compared to HIV-negative veterans
Increased COPD among HIV-positive compared to HIV-negative veterans
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DOI：
10.1378/chest.130.5.1326
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发表时间：
2006-11-01
期刊：
影响因子：
9.6
通讯作者：
Justice, Amy C.
中科院分区：
文献类型：
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作者：
Crothers, Kristina;Butt, Adeel A.;Justice, Amy C.
背景：高效抗逆转录病毒治疗(HAART)前的有限数据表明，那些HIV感染者患COPD的风险增加。我们试图确定HIV感染是否与HAART时代COPD患病率的增加有关。方法：对1014名HIV阳性和713名HIV阴性的男性进行前瞻性观察研究，这些男性参加了退伍军人老龄化队列5现场研究。通过患者自我报告和国际疾病分类第九版(ICD-9)、诊断代码来确定COPD。吸烟和注射毒品(IDU)由自我报告确定，酒精滥用由ICD-9诊断代码确定。结果：经ICD-9编码检测，HIV阳性患者COPD患病率为10%，HIV阴性患者COPD患病率为9%(p=0.4)，患者自评COPD患病率分别为15%和12%(p=0.04)。在调整了年龄、种族/民族、吸烟年限、吸毒和酗酒因素后，HIV感染是COPD的独立危险因素。HIV感染者患慢性阻塞性肺疾病的概率比非HIV感染者高50~60%(ICD9编码：优势比[OR]，1.47；95%可信区间[CI]，1.01~2.13；p=0.04；患者自评：OR：1.58；95%CI，1.14~2.18；p=0.005)。结论：无论是ICD9编码还是病人自报，HIV感染都是COPD的独立危险因素。卫生保健提供者应该意识到他们的艾滋病毒阳性患者患COPD的可能性增加。HIV感染增加COPD易感性和/或加速COPD的可能性值得进一步研究，并与COPD的发病机制有关。
Background: Limited data prior to highly active antiretroviral therapy (HAART) suggested the possibility of an increased risk of COPD among those persons with HIV infection. We sought to determine whether HIV infection is associated with increased prevalence of COPD in the era of HAART.Methods: Prospective observational study of 1,014 HIV-positive and 713 HIV-negative men who were enrolled in the Veterans Aging Cohort 5 Site Study. COPD was determined by patient self-report and International Classification of Diseases, ninth revision (ICD-9), diagnostic codes. Cigarette smoking and injection drug use (IDU) were determined by self-report, and alcohol abuse was determined by ICD-9 diagnostic codes. Laboratory and pharmacy data were obtained from electronic medical records.Results: The prevalence of COPD as determined by ICD-9 codes was 10% in HIV-positive subjects and 9% in HIV-negative subjects (p = 0.4), and as determined by patient self-report was 15% and 12%, respectively (p = 0.04). After adjusting for age, race/ethnicity, pack-years of smoking, IDU, and alcohol abuse, HIV infection was an independent risk factor for COPD. HIV-infected subjects were approximately 50 to 60% more likely to have COPD than HIV-negative subjects (by ICD-9 codes: odds ratio [OR], 1.47; 95% confidence interval [CI], 1.01 to 2.13; p = 0.04; by patient self-report: OR, 1.58; 95% CI, 1.14 to 2.18; p = 0.005).Conclusions: HIV infection was an independent risk factor for COPD, when determined either by ICD-9 codes or patient self-report. Health-care providers should be aware of the increased likelihood of COPD among their HIV-positive patients. The possibility that HIV infection increases susceptibility to and/or accelerates COPD deserves further investigation and has implications regarding the pathogenesis of COPD.