ArticleInternational journal of chronic obstructive pulmonary disease2011
Prevalence and risk factors for unrecognized obstructive lung disease among urban drug users.
Article in International journal of chronic obstructive pulmonary disease, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed, 35 citations in OpenAlex.
- Rescue Analgesia for Opioid-Dependent Individuals on Opioid Agonist Treatment during Hospitalization: Adherence to Guideline Treatment.European addiction research · 2023Article
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- Prevalence and burden of obstructive lung disease in the urban poor population of Ottawa, Canada: a community-based mixed-method, observational study.BMC public health · 2021Observational
- Association of Lung Function With HIV-Related Quality of Life and Health Care Utilization in a High-Risk Cohort.Journal of acquired immune deficiency syndromes (1999) · 2020Article
- Prevalence and correlates of obstructive lung disease among people who inject drugs, San Diego, California.Drug and alcohol dependence · 2020Article
- Too much or too little opioids to patients receiving opioid agonist therapy in Norway (2013-2017): a prospective cohort study.BMC health services research · 2020Article
- Lung function in men with and without HIV.AIDS (London, England) · 2020Observational
- Obstructive Lung Disease in HIV-Phenotypes and Pathogenesis.Current HIV/AIDS reports · 2019Review
- Accuracy of electronic health record data for the diagnosis of chronic obstructive pulmonary disease in persons living with HIV and uninfected persons.Pharmacoepidemiology and drug safety · 2019Article
- Impact of a medical home model on costs and utilization among comorbid HIV-positive Medicaid patients.The American journal of managed care · 2018Article
- Abnormal Lung Function in HIV-infected Adults: An Under-recognized Risk Factor for Early Mortality.Annals of the American Thoracic Society · 2018Article
- Article
- Obstructive Lung Diseases in HIV: A Clinical Review and Identification of Key Future Research Needs.Seminars in respiratory and critical care medicine · 2016Review
- Association of COPD With Risk for Pulmonary Infections Requiring Hospitalization in HIV-Infected Veterans.Journal of acquired immune deficiency syndromes (1999) · 2015Article
- Factors associated with abnormal spirometry among HIV-infected individuals.AIDS (London, England) · 2015Article
- HIV Infection Is Associated With Increased Risk for Acute Exacerbation of COPD.Journal of acquired immune deficiency syndromes (1999) · 2015Article
- HIV-associated obstructive lung diseases: insights and implications for the clinician.The Lancet. Respiratory medicine · 2014Review
- The complexity of HIV persistence and pathogenesis in the lung under antiretroviral therapy: challenges beyond AIDS.Viral immunology · 2014Review
- A cross sectional analysis of the role of the antimicrobial peptide cathelicidin in lung function impairment within the ALIVE cohort.PloS one · 2014Observational
- The effect of HIV infection on longitudinal lung function decline among IDUs: a prospective cohort.AIDS (London, England) · 2013Article
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundObstructive lung disease (OLD) is frequently unrecognized and undertreated. Urban drug users are at higher risk for OLD due to race, behavioral, and socioeconomic characteristics, yet little data exist on prevalence and risk factors associated with unrecognized OLD in this population.
objectiveThe objective of this study is to determine the prevalence of unrecognized OLD in an urban population and identify the characteristics associated with lack of physician-diagnosed OLD.
designCross-sectional analysis from the Acquired Immunodeficiency Syndrome Linked to the Intravenous Experience (ALIVE) study, an observational study of current and former injection drug users in Baltimore, Maryland, USA.
participantsAll participants with spirometry-defined airflow obstruction were stratified by the presence or absence of physician diagnosis of OLD. MAIN MEASURES: Using cross-sectional demographic, clinical, and spirometric measurements, multivariable regression models were generated to identify factors independently associated with unrecognized OLD. KEY
resultsOf the 1083 participants evaluated in the ALIVE lung substudy, 176 (16.3%) met spirometric criteria for OLD. Of those, only 88 (50%) had a physician diagnosis of OLD. The prevalence of unrecognized OLD decreased as severity of airflow obstruction increased. Factors independently associated with unrecognized OLD were absence of respiratory symptoms (prevalence ratio [PR], 1.70; 95% confidence interval [CI]: 1.29-2.23; P < 0.01) and less severe dyspnea (PR, 0.83; 95% CI: 0.72-0.96, per point increase in dyspnea scale; P = 0.01). In the subset of human immunodeficiency virus (HIV)-infected participants, the use of antiretroviral therapy (ART) was independently associated with an increased prevalence of unrecognized OLD (PR, 1.93; 95% CI: 1.05-3.56; P = 0.03).
conclusionsIn a cohort of current and former urban drug users, OLD is substantially underrecognized and associated with lack of respiratory symptoms. Relying on the presence of respiratory symptoms as a trigger to perform spirometry may result in a substantial underdiagnosis of OLD in this population. HIV-infected individuals receiving ART are a population particularly vulnerable to unrecognized OLD.
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