Enfermedades pulmonares en pacientes infectados con VIH hospitalizados en el Instituto Nacional del Tórax

Abstract

Background: Pulmonary diseases are common among HIV infected patients. The prevalence of the different diseases varies greatly. Aim: To identify the different pulmonary diseases that affect a Chilean population of HIV infected patients and to identify factors associated with in hospital mortality. Material and methods: Retrospective review of the clinical records of all HIV infected patients with lung diseases discharged from our institution during a period of 3.5 years. Collection of demographic and biomedical data. Results: One hundred seventy one patients (aged 35.7 years, 86% men) had 236 episodes of lung diseases. Only 13.5% of the patients were receiving antiretroviral therapy and 18% were on pneumocystis prophylaxis. Infectious diseases accounted for 87% of the discharges, neoplasm for 5.1%. Pneumocystis jirovecii infection was responsible for 37.7% of the episodes, community acquired pneumonia was seen in 24.1% and mycobacterial diseases in 14.4%. Two or more conditions were present in 13.6%. Death during hospital stay occurred in 19.5%. Multivariate analysis identified pneumothorax as the only significant independent predictor of in-hospital mortality in patients with pneumocystis pneumonia, while nosocomial pneumonia was the only predictor of death among patients with non-pneumocystis pulmonary diseases. Conclusions: Infectious diseases were the main cause of hospitalization among Chilean HIV infected patients. Mortality among these patients remains high. Appropriate antiretroviral therapy and prophylaxis may alter pulmonary disease prevalence in the future. Every effort should be made to avoid the development of pneumothorax and nosocomial pneumonia.