Community-acquired pneumonia in HIV patients
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Published:2021-05-15
Issue:4
Volume:99
Page:22-28
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ISSN:2542-1506
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Container-title:Tuberculosis and Lung Diseases
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language:
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Short-container-title:Tuberk. bolezni lëgk.
Author:
Viktorova I. B.1ORCID, Zimina V. N.2, Dadyka I. V.3, Аndreeva I. V.3, Golovina I. A.3, Chuzhikova E. P.3
Affiliation:
1. Novokuznetsk State Institute for Doctors' Professional Development – Branch of Russian Medical Academy of Continuing Professional Education 2. Peoples’ Friendship University of Russia;
National Medical Research Center of Phthisiopulmonology and Infectious Diseases 3. Novokuznetsk Branch of Kemerovo Regional Clinical Cardiology Dispensary Named after Academician L. S. Barbarash
Abstract
The objective: to study the frequency and nature of community-acquired pneumonia (CAP) in HIV patients.Subjects and methods: The continuous longitudinal retrospective study of all cases of respiratory diseases among HIV patients (n = 185), who received in-patient treatment in the therapy department.Results. CAP was diagnosed in 38.4% (n = 71) of patients and it was the most frequent respiratory disease among HIV patients. The median CD4 count in CAP made 197.5 cells/μL, 9.1% of patients received antiretroviral therapy before hospital admission. 74.7% of CAP patients (n = 53) had lesions disseminated to several lobes. Laboratory parameters revealed in severe CAP (leukocytosis > 12 × 109/L, leukopenia < 4.0 × 109/L and thrombocytopenia < 100 × 1012/L) were associated with the degree of immunodeficiency and did not depend on the infiltration dissemination (p > 0.05). Bacteremia in CAP was detected in 20.8% of patients and it was associated with the failure of standard empiric antibiotic therapy (p < 0.05). 9.9% of CAP patients (n = 7) were diagnosed with polymicrobial infection. Lethal outcomes of CAP were recorded in 5.6% of cases (n = 4), all with severe immunosuppression (the median of CD4 count was 5 cells/μL), 2 cases had bilateral subtotal CAP and 2 suffered from polymicrobial infection.
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