In the UK there are around 101,200 people living with an infection called HIV (Human Immunodeficiency Virus). This infection can now be successfully treated with medication and people can live healthy lives with a normal life expectancy. If not treated, this infection can lead to damage to the system in the body which fights infection and other things like cancer. People with HIV can also suffer from other health problems such as heart, lung or kidney disease, this can make their general health much worse. Over time, doctors have gained a better understanding of these other health conditions and can look for them in hospital clinics. Treating them early can help people live healthier lives with HIV.
In this project we are going to look at the lung disease in people with HIV compared to people without HIV. This will be done by looking at nameless computer records from general practice and hospitals. We will look at common lung problems, smoking status, and how much people see their GP for lung problems.
We hope this study will improve the services we can offer people with HIV and help develop personalised treatment plans to help keep their lungs healthy.
Objectives:
The overall aim of this project is to quantify the amount of respiratory disease, respiratory symptoms and smoking habit presenting in primary care for PLWH compared to the general population. Our specific research objectives are to establish:
1. The prevalence of recording of people living with HIV in UK primary care
2. The prevalence of records of respiratory disease diagnoses, respiratory symptoms, treatments for respiratory diseases, secondary healthcare service usage for respiratory diseases, and current and ex-smoking in PLWH and matched controls.
3. Causes of death for PLWH compared to matched controls of people without an HIV diagnosis.
Methods and data analysis:
a) Cross sectional study to identify all cases of HIV in the CPRD on 1 July 2016 and estimate point prevalence using the whole CPRD as the denominator population. We will estimate the impact of the a priori confounders age, sex and socio-economic status on prevalence using conditional logistic regression.
b) A case-control study using all the cases of PLWH identified above and 4 matched controls comparing the prevalence of current smoking, lung diseases, respiratory symptoms, treatments, consultations and inpatient hospital admissions for respiratory diseases.
c) Cross sectional study comparing the causes of mortality for PLWH who died in each 5-year time band since its inception.
Primary:
Prevalence of Chronic Respiratory disease in people living with HIV compared to the general population.
Secondary:
1. Prevalence of current smoking, ex-smoking and non-smoking.
2. Respiratory system related consultation rate, and the prevalence of pulmonary function testing and test results.
3. Prevalence of respiratory symptoms including cough, production of phlegm, wheeze, breathlessness and shortness of breath; and the prevalent use of long term respiratory treatments, in particular inhalers
4. Mortality rates from respiratory diseases.
Fiona Pearce - Chief Investigator - University of Nottingham
Shanie Wright - Corresponding Applicant - University of Nottingham
Paul Collini - Collaborator - University of Sheffield
Rebecca Mawson - Collaborator - University of Sheffield
Richard Hubbard - Collaborator - University of Nottingham
Tricia McKeever - Collaborator - University of Nottingham
HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Practice Level Index of Multiple Deprivation