Prevalence and determinants of chronic obstructive pulmonary disease in HIV infected patients in an African country with low level of tobacco smoking

Abstract

Background: Little is known on the association between HIV infection and chronic obstructive pulmonary disease (COPD) in sub-Saharan Africa. We assessed the prevalence and investigated the determinants of COPD according to HIV status in a reference centre for HIV and tuberculosis (TB) management in Cameroon.

Methods: This case-control study involved 461 HIV-positive patients aged >18 years (cases) receiving care at the Yaounde Jamot Hospital (YJH) between November 2012 and February 2013, and in 461 age- and sex-matched HIV negative controls selected from the community through a multilevel stratified sampling. Logistic regression models were used to investigate the determinants of COPD.

Results: Each study group included 312 (67.7%) women. The mean age (standard deviation) was 42.6 (10.1) years in HIV positive group and 42.6 (10.2) years in HIV negative group. HIV infection was positively associated with COPD defined by the lower limit of normal FEV1/FVC ratio. In multivariable adjusted logistic regression, history of pulmonary TB, chronic respiratory symptoms and lower body mass index (BMI) were the main determinants of COPD in HIV infected patients (on antiretrovirals or not) regardless of the definition of COPD.

Conclusions: HIV infection is possibly a risk factor for COPD in this setting. The careful investigation of the determinants of COPD during routine diagnosis and care of people with HIV infection can aid the detection, further investigation, and improvement of the management of this group of patients.

Keywords: Africa; Biomass; COPD; HIV; Tuberculosis.