Research Bronchoscopies Do Not Adversely Affect HIV-Infected Individuals' Future Health-Care Decisions

• Published in: Chest Vol. 114; no. 1; pp. 284 - 290
• Main Authors: Lipman, Marc C.I., Stobbs, David, Madge, Sara, Miller, Riva, Johnson, Margaret A.
• Format: Journal Article
• Language: English
• Published: Northbrook, IL Elsevier Inc 01.07.1998; American College of Chest Physicians
• Subjects: Adolescent; Adult; Age Factors; Altruism; Asymptomatic; Attitude to Health; beta 2-Microglobulin - analysis; Biological and medical sciences; Bronchoalveolar Lavage - adverse effects; Bronchoalveolar Lavage - psychology; Bronchoscopy; Bronchoscopy - adverse effects; Bronchoscopy - psychology; CD4 Lymphocyte Count; Chi-Square Distribution; clinical trials; Communication; Decision Making; Female; Forecasting; Heterosexuality; HIV; HIV infection; HIV Infections - psychology; HIV Seropositivity - psychology; Human immunodeficiency virus; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infections; Male; Medical sciences; Middle Aged; Personal health; Physician-Patient Relations; Prospective Studies; Questionnaires; Respiratory diseases; Surveys and Questionnaires; HIV infection; clinical trials; bronchoscopy; Bronchoscopy; Human; Immunopathology; Seropositivity; HIV-1 virus; Bronchus; Retroviridae; Tolerance; Experimental protocol; Respiratory system; Immune deficiency; Lentivirus; Infection; Virus; Viral disease; Complication; Endoscopy; Human immunodeficiency virus; Empirical Approach; Biomedical and Behavioral Research
• ISSN: 0012-3692; 1931-3543
• DOI: 10.1378/chest.114.1.284

Asymptomatic HIV-infected individuals are increasingly recruited for studies involving invasive procedures such as bronchoscopy. We sought to determine the response to and outcome of a request for a research bronchoscopy in HIV-positive individuals with no respiratory disease, and whether this would adversely affect future decisions to have a medically indicated bronchoscopy. Prospective, semistructured, questionnaire-based study in a London teaching hospital HIV outpatient clinic. One hundred and seven consecutive HIV-infected eligible individuals. Thirty-one healthy volunteers served as a control group for the subjective response to bronchoscopy. Subjects' attitudes and responses to requests for bronchoscopy and subsequent behavior when they required medically indicated bronchoscopy. Seventy-five patients (70%) agreed to the procedure in principle, predominantly for altruistic reasons. Thirty-nine subjects underwent bronchoscopy. Five percent found it worse than expected; and 79% agreed to another research bronchoscopy (performed in 11 subjects approximately 2 years later). All patients said they would undergo bronchoscopy again for diagnostic purposes (required in seven during the study). When compared to a healthy volunteer population within the same study, postbronchoscopy symptoms were similar in frequency although somewhat different in nature. Subjects felt that a clear explanation of what was involved enhanced their participation in this research. Invasive research procedures such as bronchoscopy can be performed and are repeatable in a healthy HIV-infected population. Performance of procedures for research purposes does not appear to adversely affect future health-care decisions.