Respiratory illness in people living with HIV in the era of antiretroviral therapy

ISRCTN ISRCTN38386321
DOI https://doi.org/10.1186/ISRCTN38386321
Secondary identifying numbers RFL9065
Submission date
21/04/2017
Registration date
27/04/2017
Last edited
07/06/2023
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Respiratory
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
The human immunodeficiency virus (HIV) is a type of virus known as a retrovirus. HIV attacks and weakens the immune system, making it more difficult for a sufferer to fight infections. It is a highly contagious disease, through bodily fluids such as blood, semen and vaginal fluids. There is currently no cure for HIV, but there are a range of drug treatments (antiretroviral therapy) that can help people who are HIV positive to lead a long and full life. HIV infection is associated with a high rate of respiratory (breathing) disease despite the use of antiretroviral therapy. As the HIV positive population in the UK ages, long-term lung diseases such as COPD will become increasingly important. A better understanding of the causes of respiratory illness in this population is therefore needed to help find ways to reduce the impact of disease. The aim of this study is to look at the frequency of acute respiratory illness (a sudden illness that affects breathing) in those with HIV who have access to antiretroviral therapy compared to people without HIV.

Who can participate?
Adults who are HIV positive and those who are HIV negative.

What does the study involve?
All participants are followed for a period of 12 months. During this time they are asked to complete weekly diaries to assess the development of any acute respiratory illness. When such illnesses occur, participants are asked to attend for review - at these times the severity and duration of these acute respiratory illnesses are measured using breathing tests, blood tests, and questionnaires. In addition, samples are taken from the nose and throat using nasal swabs and lungs which are analysed to find out what has caused the condition in the laboratory.

What are the possible benefits and risks of participating?
Participants benefit from receiving the results of their lung function tests, which can also be passed onto their GP. This could help their future care. During the study participants are asked to contact one of the research team if they get any new respiratory symptoms such as coughing, blocked or runny nose, breathlessness or chest pain. If this happens the researchers will then arrange to see the participants again and to take samples. If any micro-organisms that are causing infection are identified at these times then this might help with treatment. There are no significant risks anticipated. The swabs taken from participant's noses and throats and blood testing may cause mild discomfort. In a few cases collecting samples from the chest may cause wheezing.

Where is the study run from?
Royal Free Hospital (UK)

When is the study starting and how long is it expected to run for?
September 2014 to February 2018

Who is funding the study?
National Institute for Health Research (UK)

Who is the main contact?
Dr James Brown
james.brown.14@ucl.ac.uk

Contact information

Dr James Brown
Public

Department of Respiratory Medicine
Royal Free Hospital
Pond Street
London
NW3 2QG
United Kingdom

ORCiD logoORCID ID 0000-0002-2820-5847
Phone +44 20 7794 0500 extension 34304
Email james.brown.14@ucl.ac.uk

Study information

Study designProspective observational epidemiological study
Primary study designObservational
Secondary study designEpidemiological study
Study setting(s)Hospital
Study typeNot Specified
Participant information sheet ISRCTN38386321_PIS_04Aug14_V1.2_HIVpositive.doc
Scientific titleAcute respiratory tract illness in an HIV infected population with a high uptake of antiretroviral therapy
Study hypothesisResearch questin:
Do HIV positive individuals have a higher frequency of acute respiratory illness in a setting with good access to effective antiretroviral therapy?
Ethics approval(s)NRES Committee London - Hampstead, 15/09/2014, ref: 14/LO/1409
ConditionAcute respiratory illness
InterventionAll participants will have baseline tests and then be asked to report the frequency of acute respiratory illness over a 12 month period. When participants develop an acute respiratory illness, they will be asked to complete a diary recording the severity and duration of this illness and attend to have samples taken for microbiological analysis.
Intervention typeOther
Primary outcome measureThe annual incidence of acute respiratory illness in HIV positive compared to HIV negative participants is measured over 12 months of follow-up with weekly contacts to participants.
Secondary outcome measures1. Duration of symptoms during respiratory tract illness in HIV infected and uninfected participants is measured by participant diaries completed daily during acute respiratory illness
2. Health-related quality of life measured by the St Georges Respiratory Questionnaire and EuroQoL-5D at baseline
3. Healthcare resource utilisation arising from acute respiratory illness during acute respiratory tract illness measured using participant daily diaries
4. The prevalence of positive microbial isolation in throat swabs and sputum samples at baseline
5. The prevalence of positive microbial isolation during acute respiratory illness in throat swabs and sputum samples
6. The baseline prevalence of obstructive lung disease is measured by pre-bronchodilator spirometry at baseline
Overall study start date15/09/2014
Overall study end date01/02/2018

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants140
Total final enrolment109
Participant inclusion criteriaHIV-infected cohort:
1. HIV positive
2. Willing to participate in study and able to return for review in the event of respiratory tract infections, and to participate for the duration of the study
3. 18 years or above

HIV-uninfected participants:
1. Willing to participate in study and able to return for review in the event of respiratory tract infections, and to participate for the duration of the study
2. 18 years or above
3. Consent to HIV testing
4. Negative HIV test
Participant exclusion criteria1. Unable to participate for the full duration of the study
2. Unable to return for review in the event of respiratory tract infection (for instance those living a long distance from the study site)
3. Current significant acute respiratory tract illness such as pulmonary tuberculosis, Pneumocystis jirovecii pneumonia
Recruitment start date01/12/2015
Recruitment end date01/04/2017

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Royal Free Hospital
Pond Street
London
NW3 2QG
United Kingdom

Sponsor information

University College London
University/education

Gower Street
London
WC1E 6BT
England
United Kingdom

ROR logo "ROR" https://ror.org/02jx3x895

Funders

Funder type

Government

National Institute for Health Research
Government organisation / National government
Alternative name(s)
National Institute for Health Research, NIHR Research, NIHRresearch, NIHR - National Institute for Health Research, NIHR (The National Institute for Health and Care Research), NIHR
Location
United Kingdom

Results and Publications

Intention to publish date01/02/2019
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot expected to be made available
Publication and dissemination planPlanned publication in an open-access peer reviewed journal within 12 months of study completion.
IPD sharing planThe datasets generated during and/or analysed during the current study is not expected to be made available due to existing research ethics permissions regarding data storage.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Participant information sheet version V1.2 04/08/2014 27/04/2017 No Yes
Participant information sheet version V1 17/06/2014 27/04/2017 No Yes
Results article results 29/05/2020 01/06/2020 Yes No
Dataset 13/05/2020 07/06/2023 No No
Other publications 25/02/2021 07/06/2023 Yes No
Other publications 27/06/2020 07/06/2023 Yes No
HRA research summary 28/06/2023 No No

Additional files

ISRCTN38386321_PIS_04Aug14_V1.2_HIVpositive.doc
Uploaded 27/04/2017
ISRCTN38386321_PIS_17Jun14_V1_HIVnegative.doc
Uploaded 27/04/2017

Editorial Notes

07/06/2023: Publication references and dataset added.
01/06/2020: The following changes have been made:
1. Publication reference added.
2. The final enrolment number has been added from the reference.
10/08/2017: Internal review.

Springer Nature