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Pulmonary Infiltrates in HIV-Infected Patients in the Highly Active Antiretroviral Therapy Era in Spain
- Source :
- Scopus-Elsevier
- Publication Year :
- 2001
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2001.
-
Abstract
- Objective To study the incidence, etiology, and outcome of pulmonary infiltrates (PIs) in HIV-infected patients and to evaluate the yield of diagnostic procedures. Design Prospective observational study of consecutive hospital admissions. Setting Tertiary hospital. Patients HIV-infected patients with new-onset radiologic PIs from April 1998 to March 1999. Methods The study protocol included chest radiography, blood and sputum cultures, serologic testing for "atypical" causes of pneumonia, testing for Legionella urinary antigen, testing for cytomegalovirus antigenemia, and bronchoscopy in case of diffuse or progressive PIs. Results One hundred two episodes in 92 patients were recorded. The incidence of PIs was 18 episodes per 100 hospital admission-years (95% confidence interval [CI]: 15-21). An etiologic diagnosis was achieved in 62 cases (61%). Bacterial pneumonia (BP), Pneumocystis carinii pneumonia (PCP), and mycobacteriosis were the main diagnoses. The incidences of BP and mycobacteriosis were not statistically different in highly active antiretroviral therapy (HAART) versus non-HAART patients. The incidence of PCP was lower in those receiving HAART (p =.011), however. Nine patients died (10%). Independent factors associated with higher mortality were mechanical ventilation (odds ratio [OR] = 83; CI: 4.2-1,682), age >50 years (OR = 23; CI: 2-283), and not having an etiologic diagnosis (OR = 22; CI: 1.6-293). Conclusions Pulmonary infiltrates are still a frequent cause of hospital admission in the HAART era, and BP is the main etiology. There was no difference in the rate of BP and mycobacteriosis in HAART and non-HAART patients. Not having an etiologic diagnosis is an independent factor associated with mortality.
- Subjects :
- Adult
Lung Diseases
Male
medicine.medical_specialty
HIV Infections
Internal medicine
Antiretroviral Therapy, Highly Active
Medicine
Humans
Blood culture
Pharmacology (medical)
Prospective Studies
Prospective cohort study
Aged
medicine.diagnostic_test
business.industry
Incidence (epidemiology)
Incidence
Bacterial pneumonia
virus diseases
Odds ratio
Middle Aged
Viral Load
medicine.disease
CD4 Lymphocyte Count
Pneumonia
Infectious Diseases
Immunology
Etiology
HIV-1
Sputum
Female
medicine.symptom
business
Subjects
Details
- ISSN :
- 15254135
- Volume :
- 27
- Database :
- OpenAIRE
- Journal :
- Journal of Acquired Immune Deficiency Syndromes
- Accession number :
- edsair.doi.dedup.....1d7bd605bf79ea5e94f4e51dda37a554