Screening for Chronic Obstructive Pulmonary Disease (COPD) in an Urban HIV Clinic: A Pilot Study. Academic Article uri icon

Overview

MeSH

  • Adult
  • Aged
  • Ambulatory Care Facilities
  • Female
  • Forced Expiratory Volume
  • HIV Infections
  • Humans
  • Lung
  • Male
  • Middle Aged
  • New York City
  • Pilot Projects
  • Predictive Value of Tests
  • Risk Factors
  • Sensitivity and Specificity
  • Smoking
  • Surveys and Questionnaires

MeSH Major

  • Mass Screening
  • Peak Expiratory Flow Rate
  • Pulmonary Disease, Chronic Obstructive
  • Spirometry

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 sensitivity, but abnormal peak flow shows potential as a screening tool for COPD in HIV/AIDS. These data suggest that lung function may be influenced by HIV-related factors.

publication date

  • May 2015

has subject area

  • Adult
  • Aged
  • Ambulatory Care Facilities
  • Female
  • Forced Expiratory Volume
  • HIV Infections
  • Humans
  • Lung
  • Male
  • Mass Screening
  • Middle Aged
  • New York City
  • Peak Expiratory Flow Rate
  • Pilot Projects
  • Predictive Value of Tests
  • Pulmonary Disease, Chronic Obstructive
  • Risk Factors
  • Sensitivity and Specificity
  • Smoking
  • Spirometry
  • Surveys and Questionnaires

Research

keywords

  • Journal Article

Identity

Language

  • eng

PubMed Central ID

  • PMC4410819

Digital Object Identifier (DOI)

  • 10.1089/apc.2014.0265

PubMed ID

  • 25723842

Additional Document Info

start page

  • 232

end page

  • 239

volume

  • 29

number

  • 5