HIV-Positive Patients in Pusan Servitude: Clinical and Chest Radiographic Findings

ABSTRACT

PURPOSE: To analyze the clinical and chest radiolographic findings of HIV-positive patients in Pusan survitude. MATERIALS AND METHODS: We reviewed the medical records of 74 admission cases of 41 HIV-positive patients (38 men and 3 women), confirmed in NIH and admitted to our hospital between May 1990 and September 1997. We evaluated the clinical findings including the pulmonary disease diagnosed at each admission, and using the pattern approach assessed the radiographic findings in 63 cases available among 74 admission cases. For statistical analysis the Pearson Chi-Square test was used, and the chest CT findings available in 19 cases among 17 patients were also evaluated. RESULTS: In all cases the mode of transmission was sexual contact, and they were more frequently contacted with foreigners (73%) than koreans (27%). During the follow-up period, pulmonary diseases were diagnosed in 52 (70%) of 74 admission cases. The diagnoses were pneumocystis carinii pneumonia (PCP, n=15), pneumo-nia(n=15), pulmonary tuberculosis(n=15), combined infection with PCP and pulmonary tuberculosis(n=5), and combined infection with PCP and bacterial pneumonia(n=1). The count of CD4+ lymphocyte in 33 of 55 available admissions cases was less than 50 cells/mm. In 28 patients (68%) who died, the time between confirmation of HIV-positive status to death ranged from 2 to 81 (mean, 39) months. Chest radiographs of 46 available admission cases (73%) showed the following abnormal findings: interstitial opacities(n=26), consolidation(n=17), single or multiple nodules (n=9), hilar or mediastinal lymph node enlargement(n=10), pleural effusion(n=8), cyst(n=2), mass(n=1), and pericardial effusion(n=1). Diffuse ground glass opacity was observed in eight (89%) of nine PCP cases (p<0.05), and in cases of pulmonary tubercolosis, hilar or mediastinal lymph node enlargement was frequent (p<0.05). CONCLUSION: Pulmonary diseases in HIV-positive patients in Pusan servitude were diagnosed during follow-up in 70% of cases. The majority of these diseases were infectious, and the incidence of PCP, pulmonary tuberculosis and pneumonia were similar. Diffuse ground glass opacity was more frequent in PCP, and mediastinal or hilar lymph node enlargement in pulmonary tuberculosis.