PMID- 25711330
OWN - NLM
STAT- MEDLINE
DCOM- 20151104
LR  - 20220310
IS  - 1468-1293 (Electronic)
IS  - 1464-2662 (Print)
IS  - 1464-2662 (Linking)
VI  - 16 Suppl 1
IP  - 0 0
DP  - 2015 Apr
TI  - Pulmonary function in an international sample of HIV-positive, treatment-naive 
      adults with CD4 counts > 500 cells/muL: a substudy of the INSIGHT Strategic Timing 
      of AntiRetroviral Treatment (START) trial.
PG  - 119-28
LID - 10.1111/hiv.12240 [doi]
AB  - OBJECTIVES: The aim of the study was to describe the prevalence and correlates of 
      chronic obstructive pulmonary disease (COPD) in a multicentre international 
      cohort of persons living with HIV (PLWH). METHODS: We performed a cross-sectional 
      analysis of adult PLWH, naive to HIV treatment, with baseline CD4 cell count 
      > 500 cells/muL enrolled in the Pulmonary Substudy of the Strategic Timing of 
      AntiRetroviral Treatment (START) trial. We collected standardized, 
      quality-controlled spirometry. COPD was defined as forced expiratory volume in 
      1 s:forced vital capacity (FEV1 :FVC) ratio less than the lower limit of normal. 
      RESULTS: Among 1026 participants from 80 sites and 20 countries, the median age 
      was 36 [interquartile range (IQR) 30, 44] years, 29% were female, and the median 
      time since HIV diagnosis was 1.2 (IQR 0.4, 3.5) years. Baseline median CD4 cell 
      count was 648 (IQR 583, 767) cells/muL, median viral load was 4.2 (IQR 3.5, 4.7) 
      log10 HIV-1 RNA copies/mL, and 10% had a viral load </= 400 copies/mL despite lack 
      of HIV treatment. Current/former/never smokers comprised 28%/11%/61% of the 
      cohort, respectively. COPD was present in 6.8% of participants, and varied by 
      age, smoking status and region. Forty-eight per cent of those with COPD reported 
      lifelong nonsmoking. In multivariable regression, age and pack-years of smoking 
      had the strongest associations with FEV1 :FVC ratio (P < 0.0001). There was a 
      significant effect of region on FEV1 :FVC ratio (P = 0.010). CONCLUSIONS: Our 
      data suggest that, among PLWH who were naive to HIV treatment and had CD4 cell 
      counts > 500 cells/muL, smoking and age were important factors related to COPD. 
      Smoking cessation should remain a high global priority for clinical care and 
      research in PLWH.
CI  - (c) 2015 British HIV Association.
FAU - Kunisaki, K M
AU  - Kunisaki KM
AD  - Minneapolis VA Health Care System, Minneapolis, MN, USA; University of Minnesota, 
      Minneapolis, MN, USA.
FAU - Niewoehner, D E
AU  - Niewoehner DE
FAU - Collins, G
AU  - Collins G
FAU - Nixon, D E
AU  - Nixon DE
FAU - Tedaldi, E
AU  - Tedaldi E
FAU - Akolo, C
AU  - Akolo C
FAU - Kityo, C
AU  - Kityo C
FAU - Klinker, H
AU  - Klinker H
FAU - La Rosa, A
AU  - La Rosa A
FAU - Connett, J E
AU  - Connett JE
CN  - International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) 
      START Study Group
LA  - eng
SI  - ClinicalTrials.gov/NCT00867048
SI  - ClinicalTrials.gov/NCT01797367
GR  - R01-HL096453/HL/NHLBI NIH HHS/United States
GR  - MC_UU_12023/23/MRC_/Medical Research Council/United Kingdom
GR  - UM1 AI068641/AI/NIAID NIH HHS/United States
GR  - UM1 AI120197/AI/NIAID NIH HHS/United States
GR  - R01 HL096453/HL/NHLBI NIH HHS/United States
GR  - MC_U122886352/MRC_/Medical Research Council/United Kingdom
GR  - UM1-AI068641/AI/NIAID NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - HIV Med
JT  - HIV medicine
JID - 100897392
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - CD4 Lymphocyte Count
MH  - Cross-Sectional Studies
MH  - Female
MH  - HIV Infections/*complications/immunology/*pathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prevalence
MH  - Pulmonary Disease, Chronic Obstructive/*diagnosis/*epidemiology
MH  - Risk Factors
MH  - Smoking/adverse effects
MH  - Spirometry
PMC - PMC4341938
MID - NIHMS648162
OTO - NOTNLM
OT  - HIV
OT  - Strategic Timing of AntiRetroviral Treatment (START) trial
OT  - pulmonary disease
OT  - smoking
OT  - spirometry
COIS- Conflicts of interest: None of the authors have conflicts of interest to declare.
EDAT- 2015/02/26 06:00
MHDA- 2015/11/05 06:00
PMCR- 2016/04/01
CRDT- 2015/02/26 06:00
PHST- 2014/11/21 00:00 [accepted]
PHST- 2015/02/26 06:00 [entrez]
PHST- 2015/02/26 06:00 [pubmed]
PHST- 2015/11/05 06:00 [medline]
PHST- 2016/04/01 00:00 [pmc-release]
AID - 10.1111/hiv.12240 [doi]
PST - ppublish
SO  - HIV Med. 2015 Apr;16 Suppl 1(0 0):119-28. doi: 10.1111/hiv.12240.