Prevalence of chronic obstructive pulmonary disease in the global population with HIV: a systematic review and meta-analysis

This study is registered with PROSPERO, number CRD42016052639. Findings Of 4036 studies identified, we included 30 studies (151 686 participants) from all WHO regions in the meta-analysis of COPD prevalence. 23 studies (77%) had low risk of bias, six (20%) had moderate risk of bias, and one (3%) had high risk of bias in their methodological quality. The overall prevalence of COPD was 10·5% (95% CI 6·2–15·7; I 2=97·2%; six studies) according to the lower limit of normal definition of COPD, and 10·6% (6·9–15·0; 94·7%; 16 studies) according to the fixed-ratio definition. COPD prevalence was higher in Europe and among current and ever smokers, and increased with level of income and proportion of participants with detectable HIV viral load. Prevalence of COPD was significantly higher in patients with HIV than in HIV-negative controls (pooled odds ratio 1·14, 95% CI 1·05–1·25, I 2=63·5%; 11 studies), even after adjustment for tobacco consumption (2·58, 1·05–6·35, 74·9%; four studies). Interpretation Our findings suggest a high prevalence of COPD in the global population with HIV, and an association with HIV. As such, COPD deserves more attention from HIV health-care providers, researchers, policy makers, and stakeholders for improved detection, overall proper management, and efficient control of COPD in people with HIV. Efforts to address this burden should focus on promoting the decrease of tobacco consumption and adherence to highly active antiretrovir...
Source: The Lancet Global Health - Category: International Medicine & Public Health Source Type: research