Original Research

Unexpected low frequency of respiratory symptoms in an HIV-positive urban sub-Saharan population compared to an HIV-negative control group

Maren Kummerow, Erica J. Shaddock, Kerstin Klipstein-Grobusch, Roos B. Barth, Diederick E. Grobbee, Francois D.F. Venter, Charles Feldman, Alinda Vos
Southern African Journal of HIV Medicine | Vol 20, No 1 | a1010 | DOI: https://doi.org/10.4102/sajhivmed.v20i1.1010 | © 2019 Maren Kummerow, Erica J. Shaddock, Kerstin Klipstein-Grobusch, Roos B. Barth, Diederick E. Grobbee, Francois D.F. Venter, Charles Feldman, Alinda Vos | This work is licensed under CC Attribution 4.0
Submitted: 12 July 2019 | Published: 26 September 2019

About the author(s)

Maren Kummerow, Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the, Netherlands
Erica J. Shaddock, Division of Pulmonology, Department of Internal Medicine, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa; and, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Kerstin Klipstein-Grobusch, Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; and, Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Roos B. Barth, Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht University, Utrecht, the, Netherlands
Diederick E. Grobbee, Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the, Netherlands
Francois D.F. Venter, Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Charles Feldman, Department of Internal Medicine, Faculty of Health Sciences, University the of Witwatersrand, Johannesburg, South Africa
Alinda Vos, Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; and, Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; and, Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa


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Abstract

Background: Chronic respiratory illnesses and respiratory infections are common in HIV-positive populations. It seems reasonable that HIV-positive people experience more respiratory symptoms, such as coughing and breathlessness, than those who are HIV-negative.

Objectives: This study aims to determine the frequency of respiratory symptoms in an urban African HIV-positive population.

Method: A cross-sectional study was conducted in Johannesburg, South Africa, in 2016–2017. Four groups of participants were included: HIV-positive participants (1) not yet on antiretroviral therapy (ART), (2) on first-line ART, (3) on second-line ART and (4) age- and sex-matched HIV-negative controls. Data were collected on socio-demographics, respiratory risk factors and respiratory symptoms. A logistic regression analysis was performed to determine if respiratory symptoms differed between groups and to identify determinants associated with symptoms.

Results: Overall, 547 participants were included, of whom 62% were women, with a median age of 37 years. Of these patients, 63% (347) were HIV-positive, 26% were ART-naïve, 24% were on first-line ART and 50% were on second-line ART. Cough and/or productive cough was reported by 27 (5%), wheezing by 9 (2%) and breathlessness by 118 (22%) of the participants. 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 infection and a history of airway hyper-reactivity.

Conclusion: The frequency of respiratory symptoms was low in our study population except for breathlessness. HIV-positive participants, whether or not on ART, did not experience more symptoms than HIV-negative participants.


Keywords

respiratory complaints; cough; HIV; ART; sub-saharan Africa

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