Page 310 - SAHCS HIVMed Journal Vol 20 No 1 2019

Page 6 of 7 Original Research

the HIV-negative population (15.2% of PLHIV versus respiratory symptoms more strictly and it would be helpful if
36.8% of HIV-negative participants, p < 0.01). Secondly, all studies used the same definitions.
with regard to LMIC, most of the studies from the African
countries reported that the use of wood fire was still In conclusion, the results of this study among a large group
common and responsible for a high burden of respiratory of HIV-positive and -negative patients do not support the
disease and symptoms, 28,29 whereas in our study household view that respiratory symptoms are more common among
air pollution because of open fires for cooking and heating patients with HIV.
was hardly present among the participants. Thirdly,
heterogeneity in interpretation of definitions may have Acknowledgements
confounded results among the different studies from HIC
and LMIC. Competing interests
The authors declare that they have no financial or personal
Finally, most of the studies conducted previously in Africa relationships that may have inappropriately influenced them
had a low percentage of participants on treatment with in writing this article.
ART, 21,30 whereas 74% of PLHIV in our study were on ART.
Uncontrolled HIV infection, and hence inflammation and a Authors’ contributions
high risk of pulmonary infections, would likely result in an
increased incidence of respiratory symptoms. A.V. was responsible for the study design and coordination
of data collection. E.J.S. was involved in data collection. M.K.
Despite these possible explanations for our findings, it is still performed the data analyses and was responsible for
particularly surprising that HIV-positive, ART-naïve interpretation of results under the supervision of A.V. M.K.
participants in our study hardly reported respiratory and A.V. wrote the article. E.J.S., K.K.-G., R.B.B., D.E.G.,
symptoms. A possible explanation could be the fact that the F.D.F.V. and C.F. critically revised the article. All authors gave
ART-naïve group was still young and had not had the chance final approval for the version to be published.
to develop symptoms yet. Additionally, they had a median
CD4 count of 281 cells/mm and therefore were still at low Funding
3
risk for opportunistic infections. This is supported by the
31
low prevalence of a history of tuberculosis in the ART-naïve No funding was received for this project.
group compared to the group on first- and second-line ART,
which might indicate that ART-naïve participants had not Data availability statement
had uncontrolled viremia for a long period of time. The authors confirm that the data supporting the findings of
this study are available within the article or its supplementary
Another unexpected finding of our study was that despite materials.
the high burden of respiratory infections in the past in PLHIV,
this did not result in a higher frequency of respiratory
symptoms except for breathlessness. It may be the case that, Disclaimer
given the relatively young age of the population, there was The views and opinions expressed in this article are the
still enough pulmonary reserve capacity to limit complaints authors’ own and do not reflect an official position of the
in daily life. Clearly, the next step to clarify the relationship authors’ institutions.
between respiratory infections in the past, particularly
tuberculosis, and current pulmonary function would be to References
include lung function testing in the analysis.
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