HIV-AIDS patients with respiratory manifestation: study at tertiary care center

Abstract

Background: HIV affects virtually all organ systems in the body. Pulmonary disease is one of the most frequent complications of HIV infection. It is found in mostly married, young and middle aged, urban poor with male preponderance and heterosexual and blood transfusion being the commonest source of infection. Prompt diagnosis and early management may hasten the clinical recovery and reduce the risk and severity of toxic drug effects. Moreover knowledge regarding the incidence and early manifestations may help in developing strategies regarding prophylactic therapy of various infections of respiratory system. Aim of this study was to find the Incidence, occurrence and pattern of respiratory infections in HIV infected patients, use of various drugs used and response of therapy in respiratory infections and to study impact of HAART in PLHA with respiratory infection.  Methods: Fifty HIV infected patients showing clinical evidence of respiratory system involvement and admitted in our hospital from May 2014 to November 2015 were studied in present study. Clinical history was noted and detailed physical examination, laboratory evaluation and specialized tests were carried out in all patients looking especially for presence of associated opportunistic infections in other systems.Results: Cough and dyspnea were the prominent respiratory symptoms and commonest sign was consolidation (42%) and effusion (24%) or no respiratory signs (26%).Tuberculosis (66%) followed by bacterial pneumonia (24%) including recurrent bacterial pneumonia (6%), PCP (8%) and fungal infection (2%), were the commonest respiratory manifestations. Commonest organisms isolated in bacterial pneumonia were Streptococcus Pneumonia, Staph aureus and Klebsiella. Incidence of pulmonary TB was 66%. PCP was found in 8% of cases. HAART combination of lamivudine, stavudine and nevirapine were found efficacious, safe and well tolerated when combined with other antibiotics and/or AKT.Conclusions: Heterosexual exposure (70%) and blood borne infection (18%) were commonest route of infection. Fever and weight loss was commonest presenting constitutional symptoms and all patients either belonged to B or C category.