Respiratory symptoms and chronic bronchitis in people with and without HIV infection

C. A. Sabin, K. M. Kunisaki, E. Bagkeris, F. A. Post, M. Sachikonye, M. Boffito, J. Anderson, P. W.G. Mallon, I. Williams, J. H. Vera, M. Johnson, D. Babalis, A. Winston

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Objectives: High rates of respiratory symptoms and chronic bronchitis (CB) are reported in people with HIV infection (PWH). We investigated the prevalence of respiratory symptoms and CB in PWH and HIV-negative people in the Pharmacokinetic and clinical Observations in PeoPle over fiftY (POPPY) study. Methods: Assessment of respiratory symptoms and CB was undertaken using the modified form of the St. George’s Respiratory Questionnaire for chronic obstructive pulmonary disease (COPD). Univariate (χ2 tests, Mann–Whitney U tests and Spearman’s rank correlation) and multivariable (linear and logistic regression) analyses were performed to consider associations of respiratory symptoms with demographic, lifestyle and HIV-related parameters, and with depressive symptoms and quality of life. Results: Among the 619 participants, respiratory Symptom scores were higher in older and younger PWH compared to older HIV-negative people, with median (interquartile range) scores of 17.7 (6.2, 39.5), 17.5 (0.9, 30.0) and 9.0 (0.9, 17.5), respectively (P = 0.0001); these differences remained significant after confounder adjustment. Sixty-three participants (10.2%) met the criteria for CB [44 (14.0%) older PWH, 14 (9.2%) younger PWH, and five (3.3%) older HIV-negative people; P = 0.002], with these differences also remaining after adjustment for confounding variables, particularly smoking status [older vs. younger PWH: odds ratio (OR) 4.48 (95% confidence interval (CI) 1.64, 12.30); P = 0.004; older PWH vs. HIV-negative people: OR 4.53 (95% CI 1.12, 18.28); P = 0.03]. Respiratory symptoms and CB were both associated with greater depressive symptom scores and poorer quality of life. No strong associations were reported between CB and immune function, HIV RNA or previous diagnosis of any AIDS event. Conclusions: Respiratory symptoms and CB are more common in PWH than in demographically and lifestyle-similar HIV-negative people and are associated with poorer mental health and quality of life.

Original languageEnglish (US)
Pages (from-to)11-21
Number of pages11
JournalHIV Medicine
Volume22
Issue number1
DOIs
StatePublished - Sep 6 2020

Bibliographical note

Funding Information:
Financial disclosure: The POPPY study is funded by investigator‐initiated grants from BMS, Gilead Sciences, Janssen, Merck and ViiV Healthcare (EudraCT Number: 2012‐003581‐40; Sponsor Protocol Number: CRO1992). The study is also supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Imperial College Healthcare NHS Trust and Imperial College London and by an NIHR Senior Investigator Award to Professor C. A. Sabin. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. The funders have no role in the work that is undertaken in the cohort, including the collection, analysis and interpretation of data, in the writing of manuscripts or in the decision to submit work for publication.

Funding Information:
: CAS reports personal fees from Gilead Sciences and ViiV Healthcare. KMK reports personal fees from Nuvaira, Inc. FAP reports grants and/or personal fees from Imperial College London, Gilead Sciences, ViiV Healthcare, MSD and Janssen. MB has received travel and research grants from, and has been advisor for Janssen, Roche, ViiV, Bristol‐Myers Squibb, Merck Sharp & Dohme, Gilead Sciences, Mylan, Cipla and Teva. JA reports grants, personal fees and/or nonfinancial support from Imperial College, Gilead Sciences, ViiV, MSD and Jansen. PWGM reports grants and/or personal fees from Imperial College London, Gilead Sciences, MSD, ViiV Healthcare and Janssen. JHV reports grants from Imperial College London. DB reports grants from Imperial College London, Gilead Sciences, ViiV Healthcare, BMS, Janssen and MSD for the POPPY study. AW reports grants and/or personal fees from Gilead Sciences, ViiV Healthcare, BMS, Janssen and MSD. EB, IW, MS and MJ report no competing interests. Conflicts of interest

Funding Information:
We would like to thank all participants and staff involved in the POPPY study. POPPY management team: Marta Boffito, Paddy Mallon, Frank Post, Caroline Sabin, Memory Sachikonye, Alan Winston, Amalia Ndoutoumou and Daphne Babalis. POPPY Scientific Steering Committee: Jane Anderson, David Asboe, Marta Boffito, Lucy Garvey, Paddy Mallon, Frank Post, Anton Pozniak, Caroline Sabin, Memory Sachikonye, Jaime Vera, Ian Williams and Alan Winston. POPPY Sites and Trials Unit (alphabetical): Caldecot Centre, King’s College Hospital (Frank Post, Lucy Campbell, Selin Yurdakul, Sara Okumu, Louise Pollard and Beatriz Santana Suarez), Department of Infection and Population Health, University College London (Ian Williams, Damilola Otiko, Laura Phillips, Rosanna Laverick, Michelle Beynon, Anna-Lena Salz and Abigail Severn), Elton John Centre, Brighton and Sussex University Hospital (Martin Fisher, Amanda Clarke, Jaime Vera, Andrew Bexley, Celia Richardson, Sarah Kirk and Rebecca Gleig), HIV Molecular Research Group, School of Medicine, University College Dublin (Paddy Mallon, Alan Macken, Bijan Ghavani-Kia, Joanne Maher, Maria Byrne, Ailbhe Flaherty and Aoife McDermott), Homerton Sexual Health Services, Homerton University Hospital (Jane Anderson, Sifiso Mguni, Rebecca Clark, Rhiannon Nevin-Dolan and Sambasivarao Pelluri), Ian Charleson Day Centre, Royal Free Hospital (Margaret Johnson, Nnenna Ngwu, Nargis Hemat, Anne Carroll, Sabine Kinloch, Mike Youle and Sara Madge), Imperial Clinical Trials Unit, Imperial College London (Amalia Ndoutoumou and Daphne Babalis), St. Mary’s Hospital London, Imperial College Healthcare NHS Trust (Alan Winston, Lucy Garvey, Jonathan Underwood, Lavender Tembo, Matthew Stott, Linda McDonald and Felix Dransfield), St Stephen’s Centre, Chelsea and Westminster Hospital (Marta Boffito, David Asboe, Anton Pozniak, Margherita Bracchi, Nicole Pagani, Maddalena Cerrone, Daniel Bradshaw, Francesca Ferretti, Chris Higgs, Elisha Seah, Stephen Fletcher, Michelle Anthonipillai, Ashley Moyes, Katie Deats, Irtiza Syed, Clive Matthews and Peter Fernando). POPPY methodology/ statistics/analysis: Caroline Sabin, Davide De Francesco and Emmanouil Bagkeris.

Publisher Copyright:
© 2020 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association

Keywords

  • HIV infection
  • chronic bronchitis
  • immunosuppression
  • patient-reported outcome measures
  • respiratory symptoms

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