The effect of HIV status on the frequency and severity of acute respiratory illness.
Adult
Anti-HIV Agents
/ therapeutic use
Cohort Studies
Female
HIV Infections
/ complications
HIV Seronegativity
HIV Seropositivity
/ complications
Humans
Incidence
London
/ epidemiology
Male
Middle Aged
Patient Acceptance of Health Care
Prospective Studies
Quality of Life
Respiratory Tract Infections
/ complications
Severity of Illness Index
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
18
12
2019
accepted:
24
04
2020
entrez:
30
5
2020
pubmed:
30
5
2020
medline:
4
8
2020
Statut:
epublish
Résumé
Antiretroviral therapy has improved the health of people living with HIV (PLW-HIV), though less is known about how this impacts on acute respiratory illness. These illnesses are a common cause of ill health in the general population and any increase in their frequency or severity in PLW-HIV might have significant implications for health-related quality of life and the development of chronic respiratory disease. In a prospective observational cohort study following PLW-HIV and HIV negative participants for 12 months with weekly documentation of any acute respiratory illness, we compared the frequency, severity and healthcare use associated with acute respiratory illnesses to determine whether PLW-HIV continue to have a greater frequency or severity of such illnesses despite antiretroviral therapy. We followed-up 136 HIV positive and 73 HIV negative participants for 12 months with weekly documentation of any new respiratory symptoms. We found that HIV status did not affect the frequency of acute respiratory illness: unadjusted incidence rates per person year of follow-up were 2.08 illnesses (95% CI 1.81-2.38) and 2.30 illnesses (1.94-2.70) in HIV positive and negative participants respectively, IRR 0.87 (0.70-1.07) p = 0.18. However, when acute respiratory illnesses occurred, PLW-HIV reported more severe symptoms (relative fold-change in symptom score 1.61 (1.28-2.02), p <0.001) and were more likely to seek healthcare advice (42% vs 18% of illnesses, odds ratio 3.32 (1.48-7.39), p = 0.003). After adjustment for differences in baseline characteristics, PLW-HIV still had higher symptom scores when unwell. HIV suppression with antiretroviral therapy reduces the frequency of acute respiratory illness to background levels, however when these occur, they are associated with more severe self-reported symptoms and greater healthcare utilisation. Exploration of the reasons for this greater severity of acute respiratory illness may allow targeted interventions to improve the health of people living with HIV. ISRCTN registry (ISRCTN38386321).
Identifiants
pubmed: 32469981
doi: 10.1371/journal.pone.0232977
pii: PONE-D-19-35060
pmc: PMC7259631
doi:
Substances chimiques
Anti-HIV Agents
0
Banques de données
ISRCTN
['ISRCTN38386321']
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0232977Subventions
Organisme : Department of Health
ID : DRF-2015-08-210
Pays : United Kingdom
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Lancet. 2007 Jul 7;370(9581):59-67
pubmed: 17617273
Lancet Infect Dis. 2015 Jul;15(7):810-8
pubmed: 26070969
J Acquir Immune Defic Syndr. 2015 May 1;69(1):68-74
pubmed: 25942460
Lancet Glob Health. 2018 Feb;6(2):e193-e202
pubmed: 29254748
Thorax. 2018 May;73(5):431-438
pubmed: 29331988
Respir Med. 1991 Sep;85 Suppl B:25-31; discussion 33-7
pubmed: 1759018
Lancet HIV. 2015 Jun;2(6):e243-51
pubmed: 26423197
Eur Respir J. 2017 Mar 02;49(3):
pubmed: 28254767
Thorax. 2017 Apr;72(4):355-366
pubmed: 27965402
PLoS One. 2013;8(3):e58812
pubmed: 23554932
Immunol Rev. 2013 Jul;254(1):78-101
pubmed: 23772616
Lancet Respir Med. 2014 Jul;2(7):583-92
pubmed: 24831854
Lancet Respir Med. 2014 Jun;2(6):445-54
pubmed: 24717637
PLoS One. 2013 Apr 30;8(4):e61949
pubmed: 23646111
Am J Respir Crit Care Med. 1997 Jan;155(1):72-80
pubmed: 9001292
Lancet HIV. 2017 Aug;4(8):e349-e356
pubmed: 28501495
Lancet HIV. 2014 Oct;1(1):e32-40
pubmed: 26423814
Eur Respir J. 2005 Aug;26(2):319-38
pubmed: 16055882
AIDS. 2012 Jan 2;26(1):87-94
pubmed: 22008657
Curr Opin HIV AIDS. 2017 Nov;12(6):540-547
pubmed: 28799997
AIDS. 2016 Jan 28;30(3):455-63
pubmed: 26765938
Lancet Public Health. 2017 Jan;2(1):e35-e46
pubmed: 29249478
J Acquir Immune Defic Syndr. 2013 Nov 1;64(3):271-8
pubmed: 23979001
Lancet. 2014 Jul 19;384(9939):241-8
pubmed: 25042234
Eur Respir J. 2012 Dec;40(6):1324-43
pubmed: 22743675
Clin Infect Dis. 2008 Nov 15;47(10):1345-53
pubmed: 18834317
HIV Med. 2017 Sep;18(8):604-612
pubmed: 28294498