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Spectrum of Pulmonary Infections in HIV Positive Patients: Indian Scenario FREE TO VIEW

Sanjeev Sinha, MD*; Randeep Guleria, MD, DM
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AIIMS, New Delhi, India


Chest. 2004;126(4_MeetingAbstracts):917S-b-918S. doi:10.1378/chest.126.4_MeetingAbstracts.917S-b
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PURPOSE:  The aims of the present study was to see the radiological, clinical and bacteriological profile of pulmonary infection in human immunodeficiency virus (HIV) positive patients in India.

METHODS:  All consecutive HIV positive patients with clinical and/or radiological evidence of pulmonary infection have been included in the study. Sputum samples were sending for AFB smear and culture, Pneumocystis carinii infection, bacterial Gram staining and culture and fungus smear and culture was done in all patients. Also sample or biopsy was taken from other sites i.e. pleural fluid and lymph nodes. CD4/CD8 count and viral load was also done as a part of initial evaluation.

RESULTS:  85 (69 males and 16 females) HIV positive patients have been enrolled in the study. The mean value of age was 33.4±9.1 (range; 20-65 years. Radiological findings were as follows; Pleural effusion in 21, military mottling in 16, hilar lymph nodes in 19, consolidation in 11, alveolar shadows in 10 and calcified lesions in 8 patients. CD4 cells were less than 400 in 60 patients and more than 400 in 16 patients. HIV viral load (copies/ml) was less than 50,000 in 18 patients and were more than 50,000 in 27 patients. Fiber optic bronchoscopy has been performed in three patients and found PCP positive in one patient. 5 patients were diagnosed as PCP on sputum examination. In 12 patients the sputum grew fungus (Candida albicans). Pleural effusion was present in 16 patients; 11 were tubercular, 3 were Klebsiella and 2 grew Pseudomonas on culture. The overall spectrum of pulmonary infections in HIV positive patients was as follows; pulmonary tuberculosis in 40, bacterial pneumonia in 16, fungal infections in 15, Pneumocystis carinii were positive in 5, tubercular meningitis in 2 and toxoplasmosis was seen in 1 patient.

CONCLUSION:  Tuberculosis was found the most common pulmonary infection in HIV positive patients followed by bacterial and fungal infection.

CLINICAL IMPLICATIONS:  Tuberculosis is the commonly occurring pulmonary infection in HIV positive patients.

DISCLOSURE:  S. Sinha, None.

Wednesday, October 27, 2004

12:30 PM - 2:00 PM




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