Page 305 - SAHCS HIVMed Journal Vol 20 No 1 2019

Southern African Journal of HIV Medicine
ISSN: (Online) 2078-6751, (Print) 1608-9693
Page 1 of 7 Original Research

Unexpected low frequency of respiratory symptoms

in an HIV-positive urban sub-Saharan population

compared to an HIV-negative control group

Authors: Background: Chronic respiratory illnesses and respiratory infections are common in HIV-
Maren Kummerow 1 positive populations. It seems reasonable that HIV-positive people experience more
Erica J. Shaddock
2,3
Kerstin Klipstein-Grobusch respiratory symptoms, such as coughing and breathlessness, than those who are HIV-
1,4
Roos B. Barth negative.
5
Diederick E. Grobbee 1
Francois D.F. Venter 6 Objectives: This study aims to determine the frequency of respiratory symptoms in an urban
Charles Feldman 7 African HIV-positive population.
Alinda Vos 1,5,6
Method: A cross-sectional study was conducted in Johannesburg, South Africa, in 2016–2017.
Affiliations: Four groups of participants were included: HIV-positive participants (1) not yet on antiretroviral
1 Julius Global Health, Julius
Center for Health Sciences therapy (ART), (2) on first-line ART, (3) on second-line ART and (4) age- and sex-matched
and Primary Care, University HIV-negative controls. Data were collected on socio-demographics, respiratory risk factors
Medical Center Utrecht, and respiratory symptoms. A logistic regression analysis was performed to determine if
Utrecht University, Utrecht, respiratory symptoms differed between groups and to identify determinants associated with
the Netherlands
symptoms.
2 Division of Pulmonology, Results: Overall, 547 participants were included, of whom 62% were women, with a median
Department of Internal age of 37 years. Of these patients, 63% (347) were HIV-positive, 26% were ART-naïve, 24% were
Medicine, Charlotte Maxeke
Johannesburg Academic on first-line ART and 50% were on second-line ART. Cough and/or productive cough was
Hospital, Johannesburg, reported by 27 (5%), wheezing by 9 (2%) and breathlessness by 118 (22%) of the participants.
South Africa The frequency of these symptoms did not differ by HIV status after adjustment for age and
sex. Breathlessness was associated with age, female sex, obesity, a history of respiratory
3 Faculty of Health Sciences,
University of infection and a history of airway hyper-reactivity.
the Witwatersrand, Conclusion: The frequency of respiratory symptoms was low in our study population except
Johannesburg, South Africa
for breathlessness. HIV-positive participants, whether or not on ART, did not experience more
4 Division of Epidemiology and symptoms than HIV-negative participants.
Biostatistics, School of Public
Health, Faculty of Health Keywords: respiratory complaints; cough; HIV; ART; sub-saharan Africa.
Sciences, University of
the Witwatersrand,
Johannesburg, South Africa Introduction

5 Department of Internal In the last two decades, the introduction of antiretroviral therapy (ART) has substantially
Medicine and Infectious improved life expectancy of HIV-positive patients. Patients who are adequately treated with ART
Diseases, University Medical
Center Utrecht, Utrecht have a near-normal lifespan compared to the general population and, as a consequence, HIV has
University, Utrecht, become a chronic disease. One of the reasons for the increase in life expectancy in HIV-positive
1
the Netherlands patients on ART is the lower frequency of severe and life-threatening opportunistic lung infections,
such as tuberculosis and bacterial pneumonia. 2
6 Wits Reproductive Health
and HIV Institute, Faculty of
Health Sciences, University However, non-communicable chronic respiratory illnesses, such as chronic obstructive pulmonary
of the Witwatersrand, disease (COPD), are more frequently seen in people living with HIV (PLHIV) compared to people
Johannesburg, South Africa
3
without HIV. Studies have shown that PLHIV report more respiratory symptoms, such as
4
coughing, productive cough and shortness of breath. This is of interest when considering
that PLHIV are ageing and respiratory symptoms are more frequent in an older population.
5
7 Department of Internal Medicine, Faculty of Health Sciences, University the of Witwatersrand, Johannesburg, South Africa
Read online: Corresponding author: Alinda Vos, [email protected]
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Scan this QR Dates: Received: 12 July 2019 | Accepted: 22 July 2019 | Published: 26 Sept. 2019
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Copyright: © 2019. The Authors. Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.
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