Characteristics of the study population.

<p>*0.01 < p-value < 0.5.</p><p>**p-value < 0.01.</p>1<p>Categories are not mutually exclusive.</p

Associations between risk factors and lack of ART initiation among HIV-seropositive patients with CD4 at or below 350 cells/mm³ enrolled in CNICS (including deaths) with inverse probability of censoring weighting, 2003–2012.

<p>Associations between risk factors and lack of ART initiation among HIV-seropositive patients with CD4 at or below 350 cells/mm³ enrolled in CNICS (including deaths) with inverse probability of censoring weighting, 2003–2012.</p

Implementation of a COPD Screening Questionnaire in an Outpatient HIV Clinic

<p>Human immunodeficiency virus (HIV) is associated with increased risk for chronic obstructive pulmonary disease (COPD); yet substantial under-recognition of COPD exists. We administered a patient-completed, physician-reviewed COPD screening tool in an outpatient HIV clinic to determine whether screening is feasible or possible. Patients attending nonacute, routine HIV care visits were provided a brief COPD screening tool, which included three questions focused on age, respiratory symptoms, and smoking history. Providers were given completed forms for review and ordered spirometry at their discretion. Forms and medical records were subsequently reviewed to determine completion and results of spirometry testing. Of the 1,510 patients screened during the study period, 968 (64%) forms were completed. After excluding 79 incomplete forms, 889 (92%) unique patient forms were included in this analysis. Among these, 204 (23%) met criteria for spirometry referral, among whom physicians ordered spirometry in 64 (31%). At 6 months following study completion, 19 (30%) of the patients referred for spirometry had the test completed, with 5 (26%) demonstrating airflow obstruction. Nearly one out of four HIV patients met indication for screening spirometry and roughly one out of four undergoing spirometry had COPD. Critical drop-offs in the screening and diagnostic process occurred at questionnaire completion and spirometry ordering. Interventions tailored to these critical steps could improve the yield from COPD screening and help to optimize the identification of COPD in high-risk HIV-infected populations. COPD screening in a clinic focused on longitudinal HIV care can effectively identify COPD among those completing the screening continuum.</p

Observed (unweighted, dots) and weighted (IPCW-weighted, lines) annual median CD4+ cell counts since start of ART stratified by cohort, age at start of ART, gender and race.

<p>Dashed lines represent important CD4+ cell count thresholds of 200, 350, and 500 cells/μL.</p

Association between clinical characteristics and lack of ART initiation across two enrollment periods among HIV-seropositive patients enrolled in CNICS (including deaths) with inverse probability of censoring weighting, 2003–2012.

<p>Association between clinical characteristics and lack of ART initiation across two enrollment periods among HIV-seropositive patients enrolled in CNICS (including deaths) with inverse probability of censoring weighting, 2003–2012.</p

Unstratified and stratified observed and weighted median (interquartile range) CD4+ cell counts for years 1, 4, 7 and 10 after start of antiretroviral therapy and the percentage of patients with weighted CD4+ cell count >500/μL at year 10.

<p>HIV: human immunodeficiency virus, ART: antiretroviral therapy, ADI: AIDS defining illness.</p>a<p>Age at the start of ART.</p>b<p>Reported mode of HIV risk exposure was categorized injection drug users (IDU) and not IDU.</p>c<p>Pre-treatment CD4+ cell count and HIV RNA were defined as the value closest to the date of start of ART up to 6 months prior.</p>d<p>Initial ART regimen was classified as NNRTI-based or PI-based. Integrase inhibitor-based regimens were too few (N = 75) to draw consistent conclusions and were thus excluded.</p>e<p>ADI at the start of ART was defined as the presence of any CDC 1993 condition at six months prior to up to one month after start of ART.</p>f<p>Hepatitis B/C co-infection was defined as having chronic infection at the start of ART.</p

Characteristics of HIV-seropositive Patients Enrolled in CNICS, 2003–2012.

<p>Characteristics of HIV-seropositive Patients Enrolled in CNICS, 2003–2012.</p

Observed (unweighted, black) and weighted (IPCW-weighted, gray) annual CD4+ cell counts (median and interquartile range) since start of ART.

<p>Dashed lines represent important CD4+ cell count thresholds of 200, 350, and 500 cells/μL.</p

Observed (unweighted, dots) and weighted (IPCW-weighted, lines) annual median CD4+ cell counts since start of ART stratified by pre-treatment CD4+ cell count and nadir CD4+ cell count.

<p>Dashed lines represent important CD4+ cell count thresholds of 200, 350, and 500 cells/μL.</p

AIDS incidence rates (open triangles) and AIDS death rates (crosses) with fitted rates and 95% confidence intervals in Rio de Janeiro between 1995 and 2004.

<p>AIDS incidence rates (open triangles) and AIDS death rates (crosses) with fitted rates and 95% confidence intervals in Rio de Janeiro between 1995 and 2004.</p