Respiratory health and people with HIV

Woman climbing by escalator

People with HIV have more respiratory health problems.

HIV positive people have impaired respiratory health, even when they have viral suppression, with antiretroviral therapy (ART), according to researchers from "HIV Medicine."

Respiratory health was compared between HIV-positive and HIV seronegative patients in outpatient services.

HIV-reactive individuals had lower rates of respiratory health quality and were more likely to report "shortness of breath" than non-HIV-reactive participants (HIV-negative).

Clinical findings remained unchanged when the analysis focused on HIV positive people treated with ART with undetectable viral load.

Respiratory health

Unexplored territory

"To our knowledge, no other study has used the results reported by patients to compare the Respiratory health In HIV-reactive and non-HIV-reactive populations, "the authors write. "Our results suggest that HIV remains associated with the loss of quality of respiratory health, which in any case is impaired, despite viral suppression with HAART," as well as peripheral neuropathy e Cognitive impairment

If you are a smoker and have HIV, it is of great To know that tobacco use severely increases the risk of myocardial infarction

Respiratory health compromises cardiac health

diseases that affect-it-heart-3

Thanks to ART, many people who are HIV-positive now have a normal life expectancy, but this cardiologic impairment complicates the lives of people over fifty, leading to new challenges.

However, rates of heart, liver and kidney disease remain high.

Research involving US military veterans also found that people with HIV had a significantly higher prevalence of chronic obstructive pulmonary disease (COPD).

Chronic obstructive pulmonary disease
1

Above: healthy lungs with cut Bronchioles and Pulmonary alveoli. Below, the same structures in the process of destruction by COPD

Classification and external resources
CID10 J40J44, J47
CID9 490496
O 606963
M 000091
e med / 373 e
MeSH C08.381.495.389
Wikipedia is not a doctor's office. Read the doctor notice

A chronic obstructive pulmonary disease (European Portuguese) ou chronic obstructive pulmonary disease (Brazilian portuguese) (COPD) Is a type of Obstructive pulmonary disease Characterized by prolonged reduction of the airway caliber and destruction of lung tissue.

The main symptoms are breathlessness e cough With production of expectoration. COPD is a progressive disease, which means it usually worsens over time.[1]

From a certain moment they begin to see difficulties in carrying out day-to-day activities, such as climbing stairs.[2] Chronic bronchitis e emphysema Are old terms used to denote different types of COPD.[2][3]

The term "chronic bronchitis" is still used today to define a productive cough that manifests itself for at least three months a year and over two years.[4]

A Inhalation of tobacco smoke Is the most common cause of COPD.

Origin: Wikipedia, the free encyclopedia. (Opens in another tab or window of your browser)

Researchers at Royal Free Hospital in London wanted to better understand the relationship between HIV infection and respiratory health in the modern ART era.

In 2015, the researchers designed a study involving 197 seropositive individuals and 93 non-HIV control patients attending HIV outpatient clinics and the hospital's sexual and reproductive health clinics.

Participants completed a questionnaire focusing on their respiratory health (St George's Respiratory Questionnaire - SGRQ) Research Council Questionnaire (MRC) on shortness of breath. Participants also underwent a spirometry test to evaluate lung function.

Translator's note. Dr. Marcus Vinicius, at São Camilo Hospital, was doing this test on me and was encouraging me to breathe: "Now, faster, deeper, a little more, you take it, issoooooooooooooooooooo" At this moment my lung was in the chair next ... lol

The mean CD4 cell count of HIV-reactive participants was 627 cells / mm3. The majority (94%) reported having taken ART, with an average duration of therapy of seven years. In general, 89% of people had undetectable viral load (below 40 copies / ml), including 93% of those taking ART.

Without intergenerational interference

There were no differences in gender, schooling or country of birth among HIV positive and non-HIV positive (negative) participants. However, people with HIV were more likely to be Caucasian / and / or Euro-descendent compared to non-reactive controls (72% vs 60%) and non-responders had a younger average age than HIV-positive people ( 43 vs. 50 years).

The psychiatric aspect

Lonely man sitting on the stairs

Both groups had similar prevalences of comorbidities such as asthma, COPD, heart disease and stroke. However, depression was more common in people with HIV (20% vs 14%).

The same proportion of both groups reported being current (30% vs. 33%) or ex (28% vs. 25%) smokers, although people with HIV smoked more cigarettes per day (15 vs. 10, p <0,001). Similar proportions of HIV-positive participants Non-reagent for the presence of antibodies to HIV Reported using current recreational drug use (30% vs. 20%), although people with HIV were more likely to report historical drug use (61% vs. 48%).

Lung function measured by spirometry was within normal limits for most people, but 11% of HIV positive people and 9% of unreacted individuals had evidence of airflow obstruction.

Respiratory Health Commitment

There was a higher prevalence of respiratory health impairment measured by SGRQ (p <0,001) and shortness of breath among people with HIV (p = 0,001) compared to participants in non-HIV serology.

"The era was common in HIV-positive participants, with 47% ... reporting this being present and of at least moderate severity, compared with 25% of HIV-negative participants," write the authors. "Using the SGRQ respiratory health questionnaire ... we found a difference of 6 score points in the mean between the HIV positive and the HIV negative groups."

Impaired respiratory health was associated with poorer lung function and depression.

Combining the Reagents and non-reagents groups, there were no significant associations between respiratory health and sex.

As well as ethnicity, smoking and drug use.

An association with higher BMI was of borderline significance.

In an analysis restricted to HIV-positive individuals, neither the current nor the lowest CD4 count was significantly associated with the score SGRQ (Opens in another tab).

No significant difference in respiratory health score was identified according to viral load.

However, there was some evidence that people with long-term HIV infection had poorer SGRQ scores.

There was also a relationship between poorer respiratory health and a longer interval between HIV diagnosis and ART initiation.
After adjusting for potential confounders, HIV infection was independently associated with an increased SGRQ score (adjusted 1,54, 95%, 1,14-2,09, p = 0,005) and higher odds of minimal moderate breathing (aOR = 2,84;% CI, 1,35-6,00, p = 0,006).

Independent of viral load. But the woman ....

These findings remained unchanged when comparing HIV-positive individuals with an undetectable viral load with Negative participants.

Women are more susceptible to these difficulties with the respiratory system.

Other significant risk factors for shortness of breath were (P = 0,001) and depression (p <0,001).

The authors offer several possible explanations for their findings:

• Pulmonary disease before the start of ART

Cardiovascular diseases and other comorbidities Not related to the lung that cause respiratory symptoms.

• Depression

• Persistent immune dysregulation despite complete viral suppression by HAART, leading to hardening of the arteries.

"Interventions that may preserve the respiratory health of people with chronic HIV infection are needed," the authors conclude. "However, because HIV infection is associated with an apparent decline in respiratory health quality.

Even in individuals who have never smoked, it remains uncertain and requires further research. "

I was morbidly obese and had great difficulty breathing.

My sleep was of poor quality and, I did not expect the weight to rise and I did a gastroplasty like that.

:O(

The lake monster

Important note. This photo is from 2009 and I just took the courage to face the gastroplasty, stomach reduction in 2011. I was even better.

Translated and revised by the dyslexic Cláudio Souza from the original inPeople with HIV have impaired respiratory health, even when viral load is undetectable. Written by Michael Carter in 23 May 2017

reviewed by Mara Macedo

Reference

Brown et al J. Respiratory health status is impaired in UK HIV-positive adults with virologically suppressed HIV infection. HIV Medicine. DOI: 10.1111 / hiv.12497 (2017).

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