RESUMO
ABSTRACT Introduction: The etiology of pulmonary infections in HIV patients is determined by several variables including geographic region and availability of antiretroviral therapy. Materials and methods: A cross-sectional prospective study was conducted from 2012 to 2016 to evaluate the occurrence of pulmonary fungal infection in HIV-patients hospitalized due to pulmonary infections. Patients' serums were tested for (1-3)-β-D-Glugan, galactomannan, and lactate dehydrogenase. The association among the variables was analyzed by univariate and multivariate regression analysis. Results: 60 patients were included in the study. The patients were classified in three groups: Pneumocystis jirovecii pneumonia (19 patients), community-acquired pneumonia (18 patients), and other infections (23 patients). The overall mortality was 13.3%. The time since diagnosis of HIV infection was shorter in the pneumocystosis group (4.94 years; p = 0.001) than for the other two groups of patients. The multivariate analysis showed that higher (1-3)-β-D-Glucan level (mean: 241 pg/mL) and lactate dehydrogenase (mean: 762 U/L) were associated with the diagnosis of pneumocystosis. Pneumocystosis was the aids-defining illness in 11 out of 16 newly diagnosed HIV-infected patients. Conclusion: In the era of antiretroviral therapy, PJP was still the most prevalent pulmonary infection and (1-3)-β-D-Glucan and lactate dehydrogenase may be suitable markers to help diagnosing pneumocystosis in our HIV population.
Assuntos
Humanos , Masculino , Feminino , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , beta-Glucanas/sangue , L-Lactato Desidrogenase/sangue , Pneumopatias Fúngicas/diagnóstico , Mananas/sangue , Biomarcadores/sangue , Estudos Transversais , Valor Preditivo dos Testes , Estudos Prospectivos , Análise de Regressão , Sensibilidade e Especificidade , Infecções Oportunistas Relacionadas com a AIDS/sangue , Pneumopatias Fúngicas/sangueRESUMO
Definitive diagnosis of pulmonary aspergillosis is difficult to establish. Thus, confirmative evidence of active fungal aggression is imperative. In this study, an immunodiffusion test was carried out on 36 cases of pulmonary aspergillosis and two groups of subjects comprising 133 patients with non-fungal diseases and 134 healthy volunteers as controls. The test was positive in 92.3% of the patients with mycetoma, in 50% of the patients with allergic bronchopulmonary aspergillosis, and in 25% of the patients with invasive aspergillosis. Results were negative in all subjects in the two control groups. The findings indicate the efficacy of the test under study for supporting the diagnosis of pulmonary aspergillosis.