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A COPD Case-Finding Program in a Large Cohort of HIV-Infected Persons
Eugenia Quiros-Roldan1, Maria Chiara Pezzoli1, Marialma Berlendis2
1Department of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, Italy.
Chronic Obstructive Pulmonary Disease (COPD) may be under-diagnosed in people with HIV. A case-finding program identified significant COPD prevalence, highlighting the need for routine screening in this population.
Area of Science:
- Pulmonology
- Infectious Diseases
- Public Health
Background:
- Guidelines for screening Chronic Obstructive Pulmonary Disease (COPD) in patients with Human Immunodeficiency Virus (HIV) are absent.
- Data on COPD under-diagnosis in HIV-infected individuals are limited.
- This study assessed the feasibility of a COPD case-finding program and its prevalence in a large HIV cohort.
Purpose of the Study:
- To determine the feasibility of a COPD case-finding program in HIV patients.
- To estimate the prevalence of undiagnosed COPD in this population.
- To evaluate the effectiveness of a multi-step screening process.
Main Methods:
- A three-step case-finding program was implemented for HIV outpatients.
- Steps included a questionnaire, portable spirometry, and diagnostic spirometry.
- Data were collected from February 2015 to January 2016.
Main Results:
- Out of 1,463 participants, 22 out of 33 (66.7%) who completed diagnostic spirometry showed evidence of COPD.
- Lower CD4+ cell counts were observed in patients with COPD exacerbations.
- The positive predictive value of the screening questionnaire and portable spirometry was 33.8%.
Conclusions:
- COPD is likely under-diagnosed in people living with HIV.
- Implementing case-finding programs for COPD is crucial in routine HIV care.
- Early detection and management of COPD in HIV patients are recommended.
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