AEGiS-14IAC: Epidemiology of difficult to diagnose pneumonia in HIV/AIDS positive patients in Maputo, Mozambic.

14th International AIDS Conference


Barcelona, Spain - July 7-12, 2002

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Epidemiology of difficult to diagnose pneumonia in HIV/AIDS positive patients in Maputo, Mozambic.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. B10248)

Bure M, Bergoin C, Viget N, Sidat A, Nunes E
CHG Bethune service de pneumologie, Bethune, France

BACKGROUND: In Mozambic Tuberculosis (TB) and AIDS are two diseases whose frequency and interaction set an acute public health problem. Management of difficult to diagnose pneumonia in HIV positive patients is difficult because of lack of sharp diagnosis means and epidemiology knowledge. The aim of this study was to determine the epidemiology of difficult-to-diagnose pneumonia and identify diagnostic factors.

METHODS: In a university hospital and over a 9 months period, 48 HIV positive patients with undiagnosed pneumonia after two sputum samples smear-negative for acid-fast bacilli and classical antibiotherapy trial and were enrolled. Clinical and biological parameters were registered. A bronchoalveolar lavage (BAL) was performed under fiberoptic bronchoscopy. BAL liquid was analysed for mycobacteria, bacteria and fungi. Macroscopic endobronchic sight and clinical evolution under empirical treatment were also taken in account in diagnostic strategy.

RESULTS: Diagnosis was assessed in 82% patients. TB and pneumocystis carinii pneumonia (PCP) were the two most frequent diseases with respectively 35% and 27% of cases. The others diseases identified were: bacterial pneumonia (8%), pulmonary kaposi sarcoma (6%), pulmonary histoplasmosis (4%), and pulmonary cryptococcosis (2%). In 18% of cases the diagnosis strategy did not yield to diagnosis. Comparison between TB and PCP patients showed no clinical or biological difference.

CONCLUSIONS: Our results were similar with literature. They confirmed the role of TB in HIV sputum smear negative patients in developing country. They enlighten the importance of PCP in Mozambique, a country where this disease was underestimated but should be taken in account by therapeutic recommendations.

Keywords: AEGIS, Pneumonia, Acquired Immunodeficiency Syndrome, HIV Infections, Pneumonia, Pneumocystis, Sputum, HIV Seropositivity, Bronchoscopy, Sarcoma, Kaposi, Respiratory Tract Infections, CD4 Lymphocyte Count, Mozambique, Human, epidemiology, diagnosisKWDaegis,pneumonia,acquiredimmunodeficiencysyndrome,hivinfections,pneumonia,pneumocystis,sputum,hivseropositivity,bronchoscopy,sarcoma,kaposi,respiratorytractinfections,cd4lymphocytecount,mozambique,human,epidemiology,diagnosis

020707
B10248

Copyright © 2002 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.