CROI 2017 Abstract e-Book

Abstract eBook

Poster and Themed Discussion Abstracts

659 SPIROMETRIC AND RADIOLOGICAL PREDICTORS OF INCIDENT COPD IN A SPANISH COHORT Francisco Fanjul , Gloria Sampériz, Javier Verdú, Helem Haydee Vilchez, Antoni Campins, Luisa Martin, María Peñaranda, Maria Angeles Ribas, María Leyes, Melchor Riera Hosp Univ Son Espases, Palma de Mallorca, Spain Background: Chronic Obstructive Pulmonary Disease (COPD) is a prevalent comorbidity in HIV-infected population. According to recent literature, up to 21% of HIV-infected individuals have obstructive ventilatory defects and more than 50% show reduced diffusing capacity. COPD may also progress more rapidly in HIV-infected population. Methods: Prospective observational cohort study including 275 middle-aged (40-69 years) HIV-infected patients randomly selected from the population followed up in Hospital Son Espases. At the inclusion in the cohort in 2009 patients underwent: a) lung function tests (LFT) including spirometry, plethysmography, diffusion capacity measures and 6MWT. b) quantitative emphysema radiological estimation measured by High-Resolution Chest CT Scan. In 2015 patients who continued follow-up were offered to repeat these tests. Smoking, comorbidities and epidemiological data including socio demographic variables were registered. Results: In 2009, 275 patients aged 48.5+-6.6 years were included. 60,7% of patients were active smokers, 17.2% had airway limitation (AL) in spirometry and 52% diffusion altered capacity. Radiological emphysema was observed in 10.5% of patients. Patient flow diagram is presented in Figure 1. At the end of follow-up, 25.4% of patients had COPD with 11% of incident cases. Radiological emphysema was observed in 25,73% of patients. Higher mortality was observed in patients with initial AL in spirometry (14,63% vs 8,1%) Possible predictors of incident COPD were compared in patients who underwent both spirometric tests and had shown no AL in the first one. Univariate analysis showed that active smoking (OR 24,88 CI95% 6,98-88,69, p<0,0001) abnormal forced expiratory flow 25-75% (50% vs 9,8%, OR 9,14, CI95%: 2.59-32.19, p<0.001) and radiological emphysema (OR 8.11, CI95% 2,36-27,78 p<0,001) were associated with higher risk of incident COPD. No differences were observed between groups in gender or age. In the multivariate analysis , only FEF 25-75% (p=0,009) and radiological emphysema (p=0,002) remained statistically significant. Conclusion: 1.- COPD initial prevalence in our cohort was high and associated higher mortality. 2.- We hypothesize that both radiological emphysema and abnormal FEF25-75% values could be early markers of incipient airway limitation, preceding most traditional spirometric COPD criteria. They could help clinicians to diagnose those patients at COPD higher risk.

Poster and Themed Discussion Abstracts

CROI 2017 284