Prevalence and Determinants of Chronic Obstructive Pulmonary Disease (COPD) in HIV+ Patients

Objectives Main objective To determine the prevalence of COPD Secondary objectives 1. To determine the prevalence (and severity) of emphysema (HRCT) 2. To Identify risk factors associated with the development of COPD and / or emphysema 3. To analyze the predictive value of measuring DLCO as a marker of emphysema by HRCT 4. To determine the prevalence of lung function abnormalities deeming specific drug treatment (bronchodilators, inhaled corticosteroids) in the absence of clinical symptoms 5. To compare the pattern of inflammatory response in patients with COPD and / or emphysema, with and without HIV infection Methodology: Cross-sectional, descriptive, study of up to 350 patients with HIV infection. All the patients will be be assessed with: 1. an standardized clinical questionnaire 2. full lung function tests 3. high resolution CT scan 4. induced sputum for bacterial culture, P. jiroveci, proinflamatory citokines (cytokines array) 5. blood analysis: hemogram; basic biochemistry; HIV predictors; autoantibodies; proinflammatory citokines (ultrasensitive ELISA); C reactive protein (ultrasensitive nephelometry) 6. exhaled gases (NO and CO) Statistical analysis: Description of the univariate distribution of the categorical or ordinal variables will be realized with a table of frequencies, and in quantitative variables by means of measures of central tendency (mean or median) and dispersion (standard deviation or 95 % confidence intervals). Depending on the normality of the distribution of variables, any comparisons will be assessed by means of parametric tests (T test; Chi2) or non parametric tests (Mann Whitney). To explore relationships between the variables of study, Kolgomorov-Smirnov for the comparison of groups and analysis of regression bivariate, and multivariate (logistic regression), will be conducted.