Bronchoscopy (BC) with bronchoalveolar lavage fluid (BALF) analysis is the most common method used in evaluating the presence of PCP in HIV+ pt. With improvements in anti-retroviral therapy, and decreased mortality of HIV pts, changes can be expected in the previous typical presentation of PCP lung infection in this group. We set out to evaluate the cytology (CY) results of BALF from HIV+ pts to determine what differences have occurred in the recovery of PCP over a nine year period.
A retrospective review of BALF CY reports was done on pts in our BC database from 7/1994-12/2002.
204 BCs were done in 182 HIV+ pts (M=138, F=44, age 41± 9yrs).The majority of CXRs showed diffuse infiltrates at the time of BC. The majority of BC were done in the first third (1994-1996) of the nine yrs. CY showed CMV, cryptococcal, herpes, and candida species in 7% of the BCs.
BALF PCP Over Nine YearsYrsPCP+ (%BC)Organism - (%BC)Total BC done (%)1994–964252531997–994349242000–02434723CONCLUSIONS: In this group of HIV+ pts, although PCP infection is common, the isolation of PCP on BC and the number of pts being evaluated by BC may be decreasing in the current era of HIV management. CY revealed additional organisms of possible infection in almost 10% of BCs.
The use of BALF cytology analysis remains an important step in the diagnosis of lung infection in HIV+ patients.
C.I. Onyiuke, None.