Screening for Chronic Obstructive Pulmonary Disease (COPD) in an Urban HIV Clinic: A Pilot Study
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 decrea...
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| Veröffentlicht in: | AIDS patient care and STDs 2015-05, Vol.29 (5), p.232-239 |
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| creator | Shirley, Daniel K Kaner, Robert J Glesby, Marshall J |
| description | 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 ( |
| doi_str_mv | 10.1089/apc.2014.0265 |
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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.</description><identifier>ISSN: 1087-2914</identifier><identifier>EISSN: 1557-7449</identifier><identifier>DOI: 10.1089/apc.2014.0265</identifier><identifier>PMID: 25723842</identifier><identifier>CODEN: APACEF</identifier><language>eng</language><publisher>United States: Mary Ann Liebert, Inc</publisher><subject>Acquired immune deficiency syndrome ; Adult ; Aged ; AIDS ; AIDS/HIV ; Ambulatory Care Facilities ; Chronic obstructive pulmonary disease ; Clinical and Epidemiologic Research ; Female ; Forced Expiratory Volume ; HIV ; HIV Infections - epidemiology ; Human immunodeficiency virus ; Humans ; Lung - physiopathology ; Male ; Mass Screening - methods ; Medical screening ; Middle Aged ; Multivariate analysis ; New York City ; Peak Expiratory Flow Rate ; Pilot Projects ; Predictive Value of Tests ; Pulmonary Disease, Chronic Obstructive - diagnosis ; Pulmonary Disease, Chronic Obstructive - epidemiology ; Pulmonary Disease, Chronic Obstructive - physiopathology ; Respiratory function ; Risk Factors ; Sensitivity analysis ; Sensitivity and Specificity ; Smoking - adverse effects ; Smoking - epidemiology ; Spirometry ; Surveys and Questionnaires ; Urban areas</subject><ispartof>AIDS patient care and STDs, 2015-05, Vol.29 (5), p.232-239</ispartof><rights>Copyright Mary Ann Liebert, Inc. May 2015</rights><rights>Copyright 2015, Mary Ann Liebert, Inc. 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c415t-d22da62007ee40074de887db1c32477fa2c9a041fa420123db6dcf64e9dfb3853</citedby><cites>FETCH-LOGICAL-c415t-d22da62007ee40074de887db1c32477fa2c9a041fa420123db6dcf64e9dfb3853</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25723842$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shirley, Daniel K</creatorcontrib><creatorcontrib>Kaner, Robert J</creatorcontrib><creatorcontrib>Glesby, Marshall J</creatorcontrib><title>Screening for Chronic Obstructive Pulmonary Disease (COPD) in an Urban HIV Clinic: A Pilot Study</title><title>AIDS patient care and STDs</title><addtitle>AIDS Patient Care STDS</addtitle><description>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.</description><subject>Acquired immune deficiency syndrome</subject><subject>Adult</subject><subject>Aged</subject><subject>AIDS</subject><subject>AIDS/HIV</subject><subject>Ambulatory Care Facilities</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Clinical and Epidemiologic Research</subject><subject>Female</subject><subject>Forced Expiratory Volume</subject><subject>HIV</subject><subject>HIV Infections - epidemiology</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Lung - physiopathology</subject><subject>Male</subject><subject>Mass Screening - methods</subject><subject>Medical screening</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>New York City</subject><subject>Peak Expiratory Flow Rate</subject><subject>Pilot Projects</subject><subject>Predictive Value of Tests</subject><subject>Pulmonary Disease, Chronic Obstructive - diagnosis</subject><subject>Pulmonary Disease, Chronic Obstructive - epidemiology</subject><subject>Pulmonary Disease, Chronic Obstructive - physiopathology</subject><subject>Respiratory function</subject><subject>Risk Factors</subject><subject>Sensitivity analysis</subject><subject>Sensitivity and Specificity</subject><subject>Smoking - adverse effects</subject><subject>Smoking - epidemiology</subject><subject>Spirometry</subject><subject>Surveys and Questionnaires</subject><subject>Urban areas</subject><issn>1087-2914</issn><issn>1557-7449</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkdtLBCEUhyWK7o-9htDL9jCbOs7o9BDEdNkg2IUur-aoU8asbjoT9N_nshXVy1E4n4fz8wPgAKMxRrw6kQs1JgjTMSJlsQa2cVGwjFFarac74iwjFaZbYCfGV4QQJwXaBFukYCTnlGyDpzsVjHHWPcPWB1i_BO-sgtMm9mFQvX03cDZ0c-9k-IAXNhoZDRzV09nFMbQOSgcfQpPq5OYR1p1Nb0_hOZzZzvfwrh_0xx7YaGUXzf7XuQseri7v60l2O72-qc9vM0Vx0WeaEC1LghAzhqZKteGc6QarnFDGWklUJRHFraQpLcl1U2rVltRUum1yXuS74Gw1dzE0c6OVcX2QnVgEO0-rCy-t-Ntx9kU8-3dBafomXKUBo68Bwb8NJvZibqMyXSed8UMUuGQs5wiXPKFH_9BXPwSX4iWKI8qTgyWVrSgVfIzBtD_LYCSW7kRyJ5buxNJd4g9_J_ihv2XlnzZOk9s</recordid><startdate>201505</startdate><enddate>201505</enddate><creator>Shirley, Daniel K</creator><creator>Kaner, Robert J</creator><creator>Glesby, Marshall J</creator><general>Mary Ann Liebert, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T2</scope><scope>7T5</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201505</creationdate><title>Screening for Chronic Obstructive Pulmonary Disease (COPD) in an Urban HIV Clinic: A Pilot Study</title><author>Shirley, Daniel K ; Kaner, Robert J ; Glesby, Marshall J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c415t-d22da62007ee40074de887db1c32477fa2c9a041fa420123db6dcf64e9dfb3853</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Adult</topic><topic>Aged</topic><topic>AIDS</topic><topic>AIDS/HIV</topic><topic>Ambulatory Care Facilities</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Clinical and Epidemiologic Research</topic><topic>Female</topic><topic>Forced Expiratory Volume</topic><topic>HIV</topic><topic>HIV Infections - epidemiology</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Lung - physiopathology</topic><topic>Male</topic><topic>Mass Screening - methods</topic><topic>Medical screening</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>New York City</topic><topic>Peak Expiratory Flow Rate</topic><topic>Pilot Projects</topic><topic>Predictive Value of Tests</topic><topic>Pulmonary Disease, Chronic Obstructive - diagnosis</topic><topic>Pulmonary Disease, Chronic Obstructive - epidemiology</topic><topic>Pulmonary Disease, Chronic Obstructive - physiopathology</topic><topic>Respiratory function</topic><topic>Risk Factors</topic><topic>Sensitivity analysis</topic><topic>Sensitivity and Specificity</topic><topic>Smoking - adverse effects</topic><topic>Smoking - epidemiology</topic><topic>Spirometry</topic><topic>Surveys and Questionnaires</topic><topic>Urban areas</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shirley, Daniel K</creatorcontrib><creatorcontrib>Kaner, Robert J</creatorcontrib><creatorcontrib>Glesby, Marshall J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>AIDS patient care and STDs</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shirley, Daniel K</au><au>Kaner, Robert J</au><au>Glesby, Marshall J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Screening for Chronic Obstructive Pulmonary Disease (COPD) in an Urban HIV Clinic: A Pilot Study</atitle><jtitle>AIDS patient care and STDs</jtitle><addtitle>AIDS Patient Care STDS</addtitle><date>2015-05</date><risdate>2015</risdate><volume>29</volume><issue>5</issue><spage>232</spage><epage>239</epage><pages>232-239</pages><issn>1087-2914</issn><eissn>1557-7449</eissn><coden>APACEF</coden><abstract>Increased smoking and a detrimental response to tobacco smoke in the lungs of HIV/AIDS patients result in an increased risk for COPD. 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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.</abstract><cop>United States</cop><pub>Mary Ann Liebert, Inc</pub><pmid>25723842</pmid><doi>10.1089/apc.2014.0265</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acquired immune deficiency syndrome Adult Aged AIDS AIDS/HIV Ambulatory Care Facilities Chronic obstructive pulmonary disease Clinical and Epidemiologic Research Female Forced Expiratory Volume HIV HIV Infections - epidemiology Human immunodeficiency virus Humans Lung - physiopathology Male Mass Screening - methods Medical screening Middle Aged Multivariate analysis New York City Peak Expiratory Flow Rate Pilot Projects Predictive Value of Tests Pulmonary Disease, Chronic Obstructive - diagnosis Pulmonary Disease, Chronic Obstructive - epidemiology Pulmonary Disease, Chronic Obstructive - physiopathology Respiratory function Risk Factors Sensitivity analysis Sensitivity and Specificity Smoking - adverse effects Smoking - epidemiology Spirometry Surveys and Questionnaires Urban areas |
| title | Screening for Chronic Obstructive Pulmonary Disease (COPD) in an Urban HIV Clinic: A Pilot Study |
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