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People living with HIV diagnosed with COPD 12 years younger than HIV-negative people, study finds

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People in Ontario living with HIV had a 34 per cent higher incidence rate of chronic obstructive pulmonary disease (COPD) and were diagnosed with the disease about 12 years younger than HIV-negative individuals, according to a study led by researchers at St. Michael’s Hospital of Unity Health Toronto and ICES.

Researchers analyzed incidences of COPD among adults 35 years and older who were living with and without HIV between 1996 and 2015 in Ontario – where over 40 per cent of Canadians living with HIV reside.

People with HIV were diagnosed with COPD at a mean age of 50 years old compared with 62 for HIV-negative individuals.

The study, publishing on Feb. 18, 2020 in CMAJ Open, is the first of its kind to examine the rates of COPD among women living with HIV — researchers found the rate of COPD among women living with HIV was 54 per cent higher than that of HIV-negative women.

“As people with HIV live longer, it is important to understand how common other illnesses are to ensure that prevention, screening and treatment strategies can be developed,” said Dr. Tony Antoniou, a scientist at the Li Ka Shing Knowledge Institute of St. Michael’s.

“We wanted to understand how common COPD is in Ontario residents with HIV because COPD is a disease that generally worsens with time, can worsen a person’s quality of life and is strongly linked to smoking,” added Dr. Antoniou, who is also an adjunct scientist at ICES, the not-for-profit research institute where the Ontario data were analyzed.

COPD affects over 380 million people worldwide and is projected to become the fourth leading global cause of death by 2030. It is potentially preventable and is strongly associated with smoking. In a sensitivity analysis, the higher prevalence of smoking in people with HIV appeared to explain the higher risk of COPD in these patients.

“While other factors may contribute to the development of COPD in people with HIV, our work highlights the importance of trying to help our patients with HIV quit smoking to prevent COPD in the first place and prevent further lung damage in people who are already diagnosed with COPD,” said Dr. Antoniou.

Dr. Antoniou would next like to explore the quality of COPD care that people living with HIV are receiving. He also hopes the medical community will begin routinely considering COPD when managing people living with HIV.

About St. Michael’s
St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future healthcare professionals in more than 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education  at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

About Unity Health Toronto
Unity Health Toronto, comprised of Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education. For more information, visit www.unityhealth.to.

ICES is an independent, non-profit research institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. In October 2018, the institute formerly known as the Institute for Clinical Evaluative Sciences formally adopted the initialism ICES as its official name. For the latest ICES news, follow us on Twitter: @ICESOntario

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