The impact of HIV on the prevalence of asthma in Uganda: a general population survey

Abstract

BackgroundHIV and asthma are highly prevalent diseases in Africa but few studies have assessed the impact of HIV on asthma prevalence in high HIV burden settings. The objective of this analysis was to compare the prevalence of asthma among persons living with HIV (PLHIV) and those without HIV participating in the Uganda National Asthma Survey (UNAS).MethodsUNAS was a population-based survey of persons aged ≥12 years. Asthma was diagnosed based on either self-reported current wheeze concurrently or within the prior 12 months; physician diagnosis; or use of asthma medication. HIV was defined based on confidential self-report. We used Poisson regression with robust standard errors to estimate asthma prevalence and the prevalence ratio (PR) for HIV and asthma.ResultsOf 3416 participants, 2067 (60.5%) knew their HIV status and 103 (5.0%) were PLHIV. Asthma prevalence was 15.5% among PLHIV and 9.1% among those without HIV, PR 1.72, (95%CI 1.07–2.75, p = 0.025). HIV modified the association of asthma with the following factors, PLHIV vs. not PLHIV: tobacco smoking (12% vs. 8%, p = < 0.001), biomass use (11% vs. 7%, p = < 0.001), allergy (17% vs. 11%, p = < 0.001), family history of asthma (17% vs. 11%, p = < 0.001), and prior TB treatment (15% vs. 10%, p = < 0.001).ConclusionIn Uganda the prevalence of asthma is higher in PLHIV than in those without HIV, and HIV interacts synergistically with other known asthma risk factors. Additional studies should explore the mechanisms underlying these associations. Clinicians should consider asthma as a possible diagnosis in PLHIV presenting with respiratory symptoms.

Chronic obstructive pulmonary disease prevalence and associated factors in an urban HIV clinic in a low income country

“…However, most data included in the above systematic review were from developed countries where smoking rates are comparatively higher than in low income Africa. In Uganda, a population based asthma survey in 2016 also showed a fairly high symptom burden among PLHIV (cough 23%, shortness of breath 18%, wheeze 11%) [26]. Like in our study, Pefura et al also reported a high respiratory symptom burden among PLHIV (47%) in urban Cameroon [27].…”

Worldwide relative smoking prevalence among people living with and without HIV

“…All MSM [47] European [56] Americas (Haïti) 100% 100% ------Cross sectional PLH and HIV seronegative: mothers of infants recruited whilst attending for a measles vaccine study. None identified [57] Americas [79] Western Pacific (China) 4.4% 3.6% ------Cross sectional PLH and HIV seronegative: former opiate users recruited from five methadone replacement clinics All PWID [48] European (France) [58] Americas (United States) ----------- [59] Americas (United States) 100% 100% ------Case control PLH and HIV seronegative: women giving birth at a large metropolitan hospital (1988-1992) All pregnant women [60] Americas (United States) 92% cisgender male; 6% transgender woman; 2% other [61] Americas (United States) [49] European (Spain) [62] Americas [63] Americas (Brazil) [72] Africa (Uganda) 67% Median = 31 (range 18-87) Cross sectional PLH and HIV seronegative: Cross sectional community based survey with prospective determination of HIV serostatus None identified [73] Africa (Uganda) 39% 61.2% ------Cross sectional PLH and HIV seronegative: General population asthma survey. HIV status selfreported.…”

Tobacco use and HIV symptom severity in Chinese people living with HIV

“…As HIV has become a chronic disease with the advent of antiretroviral therapy (ART), chronic disease symptoms associated with aging are increasingly reported (Frain et al, 2014;Iribarren et al, 2018). Symptoms including pain, sleep disturbance and low quality of life have been reported (de Souza et al, 2018;Scott et al, 2018), along with frequent presentation of chronic respiratory diseases including asthma (Kirenga et al, 2018), lung cancer, COPD, and TB, which causes spirometric restriction (Meghji et al, 2016).…”