3 research outputs found
Prevalence of chronic obstructive pulmonary disease in the global population with HIV: a systematic review and meta-analysis
Background: In recent years, the concept has been raised that people with HIV are at risk of developing chronic obstructive pulmonary disease (COPD) because of HIV infection. However, much remains to be understood about the relationship between COPD and HIV infection. We aimed to investigate this association by assessing studies that reported the prevalence of COPD in the global population with HIV.
Methods: In this systematic review and meta-analysis, we assessed observational studies of COPD in people with HIV. We searched PubMed, Embase, Web of Science, and Global Index Medicus, with no language restriction, to identify articles published until June 21, 2017, and we searched the reference lists of the retrieved articles. Eligible studies reported the prevalence of COPD or had enough data to compute these estimates. We excluded studies in subgroups of participants selected on the basis of the presence of COPD; studies that were limited to other specific groups or populations, such as people with other chronic respiratory diseases; and case series, letters, reviews, commentaries, editorials, and studies without primary data or an explicit description of methods. The main outcome assessed was prevalence of COPD. Each study was independently reviewed for methodological quality. We used a random-effects model to pool individual studies and assessed heterogeneity (I2) using the χ2 test on Cochrane's Q statistic. This study is registered with PROSPERO, number CRD42016052639.
Findings: Of 4036 studies identified, we included 30 studies (151 686 participants) from all WHO regions in the meta-analysis of COPD prevalence. 23 studies (77%) had low risk of bias, six (20%) had moderate risk of bias, and one (3%) had high risk of bias in their methodological quality. The overall prevalence of COPD was 10·5% (95% CI 6·2–15·7; I2=97·2%; six studies) according to the lower limit of normal definition of COPD, and 10·6% (6·9–15·0; 94·7%; 16 studies) according to the fixed-ratio definition. COPD prevalence was higher in Europe and among current and ever smokers, and increased with level of income and proportion of participants with detectable HIV viral load. Prevalence of COPD was significantly higher in patients with HIV than in HIV-negative controls (pooled odds ratio 1·14, 95% CI 1·05–1·25, I2=63·5%; 11 studies), even after adjustment for tobacco consumption (2·58, 1·05–6·35, 74·9%; four studies).
Interpretation: Our findings suggest a high prevalence of COPD in the global population with HIV, and an association with HIV. As such, COPD deserves more attention from HIV health-care providers, researchers, policy makers, and stakeholders for improved detection, overall proper management, and efficient control of COPD in people with HIV. Efforts to address this burden should focus on promoting the decrease of tobacco consumption and adherence to highly active antiretroviral therapy to reduce viral load.
Funding: None
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Prevalence and incidence of major depressive disorders among people living with HIV residing in Africa: a systematic review and meta-analysis protocol
Background: Depression represents one of the most frequent neuro-psychiatric diseases; it seems to be more prevalent in people living with HIV compared to the general population. However, summarized data in the African setting on the topic are scarce. This systematic review and meta-analysis aims at assessing the prevalence and incidence of major depressive disorders (MDD) in HIV-infected African populations residing in Africa. Methods and design This review will include observational studies conducted among HIV-infected people residing in Africa, which have reported either the prevalence or incidence of MDD or enough data for its appraisal. Relevant records will be searched using PubMed/Medline, EMBASE, African Journals Online, and Africa Index Medicus. In addition, reference lists of eligible papers and relevant review articles will be screened. Published studies from inception Jan 1, 2000 to Dec 31, 2017 will be considered regardless of language of publication. Two review authors will independently screen, select studies, and extract data, with discrepancies resolved by consensus or arbitration by a third review author. Methodological quality of included studies will be assessed using the scale developed by Hoy and colleagues. Funnel-plots and Egger’s test will be used to determine publication bias. The study-specific estimates will be pooled through a random-effects meta-analysis model to obtain an overall summary estimate. The heterogeneity will be evaluated by the χ2 test on Cochrane’s Q statistic. Results will be presented by geographical region and antiretroviral therapy status. Discussion This study is based on published data; therefore, ethical approval is not a requirement. The final report of this study in the form of a scientific paper will be published in a peer-reviewed journal and presented at scientific conferences. This review will help to have an overview of the burden of MDD among HIV-infected people residing in Africa. Systematic review registration PROSPERO, CRD42017058118. Electronic supplementary material The online version of this article (10.1186/s13643-018-0672-2) contains supplementary material, which is available to authorized users