Abnormal spirometric patterns and respiratory symptoms in HIV patients with no recent pulmonary infection in a periurban hospital in Ghana

Abstract

AbstractBackgroundHuman immunodeficiency virus (HIV) infection is associated with chronic pulmonary diseases, even in those with viral suppression by highly active antiretroviral treatment (HAART). Spirometry is an accurate method of diagnosing pulmonary dysfunction in people living with HIV (PLWH).AimTo compare the prevalence of spirometric abnormalities among HAART-treated HIV patients and HAART naïve HIV patients with non-HIV controls with no recent history of pulmonary infection in a peri-urban hospital in Ghana.MethodsIn a case-control design, we recruited 158 HAART-treated HIV patients, 150 HAART-naïve HIV patients and 156 non-HIV controls for the study. Clinical, sociodemographic data and respiratory symptoms were collected using a structured questionnaire. Spirometry was performed in all participants and abnormalities were categorised as obstructive (OSP) or restrictive (RSP) spirometric patterns based on the GLI definition.ResultsThe prevalence of OSP was similar among the HAART treated, HAART naïve HIV patients and non-HIV controls (10.1% vs 9.3% vs 9% respectively, p=0.994), whereas that of RSP was higher in HAART-treated HIV patients compared to HAART-naïve HIV patients and non-HIV controls (51.9% vs 32.1% vs 32% respectively, p=0.013). Respiratory symptoms were common among HAART-treated and HAART-naïve HIV patients compared to non-HIV controls (48.1% vs 40% vs 19.2% respectively, p<0.001). The major determinants of OSP were female gender, exposure to medium-to-high levels of biomass, presence of a respiratory symptom, unemployment and underweight, and that of RSP were age, female gender, being unmarried, medium-to-high biomass exposure and being self-employed or unemployed.ConclusionIn HIV patients without any recent pulmonary infection in a peri-urban area of Ghana, there was no difference in the prevalence of OSP among HAART-treated and HAART naïve HIV patients compared to the non-HIV control. However, the prevalence of RSP was higher in HAART-treated HIV patients compared to the other groups.