# Risk factors for chronic obstructive pulmonary disease exacerbations, quality of care, and outcomes in people with HIV

> **NIH NIH K08** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2024 · $163,068

## Abstract

PROJECT SUMMARY AND ABSTRACT
Chronic obstructive pulmonary disease (COPD) is an important public health problem in people with HIV (PWH).
PWH have 3-fold the odds of COPD as uninfected people after adjusting for smoking. Acute exacerbations of
COPD (AECOPD) are the principal contributor to COPD morbidity and mortality. Given the adverse effects of
AECOPD, international practice guidelines for the prevention and management of AECOPD exist in the general
population. Limited evidence suggests that HIV infection is associated with increased risk for AECOPD, but data
on the effect of HIV infection on post-AECOPD outcomes are lacking. We also lack data on quality of COPD
care or the relationship between processes of care and outcomes in PWH. Scientific aims of this K08 are to
determine: 1) risk factors for AECOPD in PWH and uninfected people; 2) the effect of HIV infection on outcomes
after AECOPD; 3) the effect of HIV infection on COPD treatment concordance with guidelines and the relation-
ship between COPD care quality and outcomes in PWH. Hypotheses: 1) HIV infection, “traditional” AECOPD
risk factors, and HIV-specific factors are associated with AECOPD with interaction effects between age, smoking,
and poorly controlled HIV infection that enhance susceptibility to AECOPD; 2) HIV infection is associated with
increased readmissions and mortality after AECOPD; 3) guideline-concordant tests and therapies are underpre-
scribed in PWH compared to uninfected people and high-quality COPD care is associated with improved out-
comes in PWH. We will test our hypotheses in a cohort study of HIV-infected and uninfected controls with ad-
ministrative and electronic health record (EHR) data from health systems across the US in a causal inference
framework using nested case-control sampling to randomly select controls and inverse probability treatment
weighting for analysis, thus emulating a target trial with HIV infection as “treatment.” Data from this study will lay
the groundwork for the candidate’s future R01 proposals to assess patient adherence to COPD therapies and to
test interventions to optimize COPD care at the patient, provider, and system level. Through an integrated train-
ing plan of intensive mentorship, didactic coursework, experiential research, and academic activities, the candi-
date will accomplish his career development goals to develop expertise in: 1) health informatics and data science
for analysis of administrative and EHR data; 2) hierarchical and longitudinal statistical modeling; 3) causal infer-
ence from observational data; and 4) leadership, communication, and knowledge dissemination skills. The re-
sources and experiences of the candidate’s mentors (Drs. Alison Morris, Katie Suda, and Scott Rothenberger),
supportive research environment at the University of Pittsburgh, and strong institutional commitment from the
Division of Pulmonary, Allergy, and Critical Care Medicine assure the successful execution of the proposed
research and...

## Key facts

- **NIH application ID:** 10868729
- **Project number:** 5K08HL169023-02
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** Ioannis Konstantinidis
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $163,068
- **Award type:** 5
- **Project period:** 2023-07-01 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10868729

## Citation

> US National Institutes of Health, RePORTER application 10868729, Risk factors for chronic obstructive pulmonary disease exacerbations, quality of care, and outcomes in people with HIV (5K08HL169023-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10868729. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*