HIV infection, pulmonary tuberculosis and COPD in rural Uganda: A cross-sectional study

Abstract
HIV is associated with chronic obstructive pulmonary disease (COPD) in high resource settings. Similar relationships are less understood in low resource settings. We aimed to estimate the association between HIV infection, tuberculosis and COPD in rural Uganda. Methods: The Uganda Non-Communicable Diseases and Aging Cohort study observes people 40 years and older living with HIV (PLWH) on antiretroviral therapy, and population-based HIV-uninfected controls in rural Uganda. Participants completed respiratory questionnaires and post-bronchodilator spirometry. Results: Among 269 participants with spirometry, median age was 52 (IQR 48–55), 48% (n=130) were ever-smokers, and few (3%, n=9) reported a history of COPD or asthma. All participants with prior tuberculosis (7%, n=18) were PLWH. Among 143 (53%) PLWH, median CD4 count was 477 cells/mm3 and 131 (92%) were virologically suppressed. FEV1 was lower among older individuals (−0.5 %pred/year, 95% CI 0.2–0.8, p<0.01) and those with a history of tuberculosis (−14.4 %pred, 95% CI −23.5 - −5.3, p < 0.01). COPD was diagnosed in 9 (4%) participants, eight of whom (89%) were PLWH, 6 of whom (67%) had a history of tuberculosis, and all of whom (100%) were men. Among 287 participants with complete symptom questionnaires, respiratory symptoms were more likely among women (AOR 3.9, 95% CI 2.0–7.7, p<0.001) and those in homes cooking with charcoal (AOR 3.2, 95% CI 1.4–7.4, p=0.008).
Description
Keywords
Spirometry, Africa, Lung function, AIDS, Tuberculosis
Citation
North, C. M., Allen, J. G., Okello, S., Sentongo, R., Kakuhikire, B., Ryan, E. T., ... & Siedner, M. J. (2018). HIV infection, pulmonary tuberculosis, and COPD in rural Uganda: a cross-sectional study. Lung, 196(1), 49-57. doi:10.1007/s00408-017-0080-8.