Respiratory insufficiency is a common problem in AIDS patients. To assess the frequency of obstructive lung disease as the cause of shortness of breath we retrospectively reviewed our experience with this disorder in AIDS patients.
We retrospectively reviewed medical records of 40 patients with obstructive lung disease and HIV (13 males, 27 females; age-range: 21-58 yrs; mean age: 41.9 yrs) hospitalized during the past two years. Patients with the diagnosis of obstructive lung disease before HIV infection were excluded. Criteria for reversibility included 12% and >200 cc increase in FEV1 or FVC after bronchodilator. Patients were divided into two groups: one with a history of drug-abuse, and the other without it. Reversibility of obstructive lung disease was then assessed in the two groups. Fisher’s exact test was used for statistical analysis.
Table 1 compares reversibility of obstructive lung disease in the two groups. Data was tested by Lillefors-KS test for normality. All sets passed, so t-test was used for comparison of data. In the second part of the study, Table 2 we looked at the relationship between the following independent variables and the risk of irreversible obstructive lung disease, using Fisher’s exact test for statistical analysis.
Table 1Drug Abuse (IVDA and SniffingNo Drug AbuseReversible obstructive lung disease8/22 (36.3%)14/18 (73.7%)Irreversible obstructive lung disease14/22 (63.6%)4/18 (22.2%)
P= 0.012Table 2Risk FactorRelative RiskP ValueDuration of HIV>10 yrs>20<0.0001IVDA and sniffing5.250.008Smoking8.750.011
1. Irreversible obstructive lung disease is more common in HIV patients with history of drug-abuse (both IVDA and sniffing). 2. Independent predictors of irreversible obstructive lung disease in HIV patients in order of significance include: a) Duration of HIV b) IVDA and sniffing c) Smoking 3. Duration of HIV is the most significant predictor of irreversible obstructive lung disease in HIV patients.
Assessment of pulmonary function is an important part of the work-up in a patient with HIV infection.
G. Wardeh, None.