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[Respective frequency and radioclinical features of 150 lung diseases observed in 125 patients with human
P De Truchis1, J Cadranel, J L Touboul
1Service de Pneumologie et de Réanimation respiratoire, Hôpital Tenon, Paris.
Abstract:
Seventy out of 125 patients with HIV infection had diffuse alveolo-interstitial pneumonia usually caused by an opportunistic infection, notably pneumocystosis. Nineteen patients had only localized lung opacities due either to usual or tuberculous bacterial infections or to Kaposi's sarcoma. In 10 patients with pleural effusion or mediastinal adenopathy, the condition was due to Kaposi's sarcoma (n = 4) or to mycobacteriosis (n = 3). An opportunistic or usual infection was demonstrated in 17 of the 51 patients with normal radiography of the chest. Finally, 37 patients free from infectious or tumoral pathology had isolated lymphocytic alveolitis.
Insights
In patients with HIV infection, opportunistic infections like pneumocystosis commonly cause diffuse lung disease. Even with normal chest X-rays, infections or lymphocytic alveolitis can be present.
Area of Science:
- Pulmonology
- Infectious Diseases
- Oncology
Background:
- Human Immunodeficiency Virus (HIV) infection is associated with a high incidence of pulmonary complications.
- Opportunistic infections and malignancies are frequent causes of lung pathology in HIV-positive individuals.
- Radiographic findings in HIV-related lung disease can be diverse, ranging from diffuse infiltrates to localized opacities.
Purpose of the Study:
- To investigate the spectrum of pulmonary pathologies in patients with HIV infection.
- To correlate clinical presentations and radiographic findings with specific underlying causes.
- To identify the prevalence of infectious and non-infectious lung diseases in this population.
Main Methods:
- Retrospective analysis of chest radiography and clinical data from 125 HIV-infected patients.
- Identification of pulmonary abnormalities including diffuse alveolo-interstitial pneumonia, localized opacities, pleural effusion, and mediastinal adenopathy.
- Microbiological and pathological investigations to confirm causative agents or diagnoses.
Main Results:
- Seventy out of 125 patients (56%) presented with diffuse alveolo-interstitial pneumonia, predominantly due to opportunistic infections like pneumocystosis.
- Nineteen patients (15%) showed localized lung opacities attributed to bacterial infections or Kaposi's sarcoma.
- Pleural effusion or mediastinal adenopathy was observed in 10 patients, linked to Kaposi's sarcoma or mycobacteriosis. Seventeen of 51 patients with normal chest X-rays had infections, and 37 had lymphocytic alveolitis.
Conclusions:
- Diffuse alveolo-interstitial pneumonia is a common manifestation of opportunistic infections in HIV patients.
- Localized lung opacities and other findings can be caused by infections or malignancies.
- Pulmonary pathology in HIV infection requires thorough investigation, as infections or inflammatory conditions can occur even with normal initial radiography.