Chronic obstructive pulmonary disease in patients infected with human immunodeficiency virus

The aim of the study was to examine the role of COPD in the structure of respiratory diseases in HIV patients and the course of these comorbidities among hospitalized patients with HIV infection.

Methods. A continuous longitudinal retrospective study was conducted in the Holy Great Martyr George the Victorious Novokuznetsk City Clinical Hospital No.2 and included all HIV patients with respiratory diseases (n = 185) hospitalized in the therapeutic department in 2017 – 2018. About 2% of population in the Kemerovo region (with the population 2.7 million people) is known to be HIV-infected. The regional COPD incidence is 124.7/100 000.

Results. COPD was diagnosed in 19 (10.3%) of all HIV patients hospitalized with respiratory diseases. 73.7% of patients with COPD were aged ≤ 40 years, the mean age was 37.6 ± 5.0 years. All patients (100.0%) were known to have smoking and intravenous drug use as potential risk factors for the development and progression of COPD. The ART coverage was low (21.1%). 68.5% of patients with COPD had severe bronchial obstruction with a decrease in FEV1 < 50% of predicted values (GOLD grades III – IV). 73.7% of the patients were assigned to COPD group B, the rest 26.3% – to group D. In 31.6% of patients, the main cause of hospitalization was COPD itself, in 68.4% – COPD combined with other lung diseases (community-acquired pneumonias, septic embolism, tuberculosis and pneumocystosis). The CD4-lymphocyte count in cases of COPD combined with other respiratory diseases (median 214.0 cell/μl) was lower than in COPD as the only respiratory disease (median 495.5 cells/μl) (p = 0,014).

Conclusion. The socio-economic significance of both HIV-infection and COPD argues the further study of the course and treatment of COPD in persons with HIV-infection.

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