[Pneumonia in HIV-infected patients: clinical observations]. / Zapalenie pluc u osób zakazonych HIV--obserwacje kliniczne.

ABSTRACT

OBJECTIVES: To determine the occurrence of pneumonias in HIV-infected patients in our hospital during 1990-1999; to evaluate the clinical significance of pneumonias in HIV-seropositive patients; to estimate the ethiology of pulmonary infection. MATERIALS AND METHODS: One hundred and two HIV-infected patients, 17 (16.6%) female and 85 (83.3%) male with mean age of 29 +/- 4.5 yrs, were retrospectively analysed. All patients had a physical examination particularly concerning the clinical symptoms of pulmonary infection, X-ray exam and tuberculin skin test (PPD). The stage of HIV infection according to the 1993 CDC classification was determined. All patients had the microbiology test of sputum (Pc, TB, fungi, other pathogen). In some cases the bronchofiberoskopy with bronchoalveolar lavage (BAL) was performed. RESULTS: One hundred and two HIV-positive patients had 129 episodes of pneumonia. We determine the bacterial ethiology in 94/129 (72.9%) cases--TB in 11/129 (8.5%) cases. Fourteen patients had 23 episodes of Pneumocystis carinii pneumonia (PcP). Three patients had CMV--pneumonitis, detected post mortem. In seven cases the ethiology of pulmonary infection was unknown. In summary the ethiology of pneumonia was determined in 58/129 (44.9%) cases. Thirty three patients were died. The pulmonary infections were main cause of death in 23 (67.7%) persons. CONCLUSIONS: In the era of high active antiretroviral therapy (HAART) the pulmonary infections in HIV-positive patients are the main cause of death as before. The PPD test is useless in HIV-positive patients. We make a note the increase cases of TB in HIV-infected patients during the time of observations.