ABSTRACT
Between July 1995 and July 1997 we diagnosed bronchiectasis confirmed by CT scan chest in 25 (18 men and 7 women) out of 295 hospitalised patients with HIV infection who suffered from lower respiratory infection. Median age at time of diagnosis of bronchiectasis was 32 years old. The patients were mostly intravenous drug addicts. In all cases a previous pulmonary infection was revealed (Pneumocystis carinii pneumonia, tuberculosis, recurrent pneumonia) with impairment of immune status (CD4 media = 64.8 mm3). Presence of persistent or intermittent cough with purulent sputum, repeated low respiratory infection and abnormal chest radiograph were correlated to bronchiectasis by chest CT scan. We conclude, that there is a significant occurrence of bronchiectasis in patients with HIV infections and pulmonary disease, thus increasing morbidity and mortality in these patients and being the cause of repeated hospitalisations due to bacterial respiratory infections.
Subject(s)
Bronchiectasis/complications , HIV Seropositivity/complications , Adult , Bronchiectasis/diagnosis , Female , Humans , Male , Substance Abuse, Intravenous/complications , Substance-Related Disorders/complicationsABSTRACT
The objectives of this study were to investigate the prevalence of infections with hepatotrophic viruses in an anti-human immunodeficiency virus (HIV)-positive population from Buenos Aires and to compare it among the main risk groups for HIV infection. Four hundred and eighty-four consecutive patients attending the HIV outpatients clinic were studied: 359 men and 125 women, median age 29 years (range 16-67 years); 35.5% had presented acquired immune deficiency syndrome (AIDS)-defining conditions. Two hundred and thirty-four patients were intravenous drug users (IVDU), 99 had homosexual and 142 heterosexual preference, seven had received blood transfusions and two had no risk factors. Hepatitis B surface antigen (HBsAg), and antibodies to hepatitis B core antigen (HBcAb) and to hepatitis C virus (anti-HCV) were investigated in all patients; antibodies to HBsAg (HBsAb) and IgG antibodies to hepatitis D virus (anti-HDV) in all HBcAb-positive patients; hepatitis B e antigen and antibodies to HBeAg (HBeAg) in all HBsAg-positive patients; IgG antibodies to hepatitis A virus (anti-HAV) in the first 307 patients; and IgG antibodies to hepatitis E virus (anti-HEV) in the first 91 patients. As control groups, contemporary voluntary blood donors were studied for prevalence of HAV, HBV, HCV and HEV. The percentages of HBcAb, HBsAg, anti-HCV and anti-HEV (58.5, 14.5, 58.5 and 6.6%, respectively) were significantly higher in anti-HIV-positive patients than in control groups (3.2, 0.5, 1.0 and 1.8%, respectively) (P = 0.000). The prevalence of HBcAb was significantly higher in IVDU (72.6%) than in heterosexuals (33.8%) (P = 0.0001) and in homosexuals (59.6%) (P = 0.0189). The percentage of HBsAg was significantly higher in IVDU (19.2%) than in heterosexuals (6.3%) (P = 0.0004). Anti-HCV was significantly higher in IVDU (92.3%) than in homosexuals (14.1%) and in heterosexuals (33.1%) (P = 0.000 in both cases). The prevalence of anti-HDV was relatively low (1.9%). There was no difference in the percentage of anti-HAV between HIV-positive and negative subjects. In conclusion, there is a high prevalence of HBV and HCV infections in HIV-positive patients from our area. Drug use is the main route of transmission, but prevalence of HCV in patients with, probably, sexually acquired HIV infection is also higher than in the control group. The increased prevalence of HEV infection in HIV-positive individuals is another provocative finding that warrants further study.
Subject(s)
HIV Infections/complications , Hepatitis, Viral, Human/epidemiology , Adolescent , Adult , Aged , Argentina/epidemiology , Female , Hepatitis Antibodies/blood , Hepatitis, Viral, Human/blood , Hepatitis, Viral, Human/complications , Hepatitis, Viral, Human/virology , Humans , Male , Middle Aged , Prevalence , Prospective Studies , Risk FactorsABSTRACT
Between July 1995 and July 1997 we diagnosed bronchiectasis confirmed by CT scan chest in 25 (18 men and 7 women) out of 295 hospitalised patients with HIV infection who suffered from lower respiratory infection. Median age at time of diagnosis of bronchiectasis was 32 years old. The patients were mostly intravenous drug addicts. In all cases a previous pulmonary infection was revealed (Pneumocystis carinii pneumonia, tuberculosis, recurrent pneumonia) with impairment of immune status (CD4 media = 64.8 mm3). Presence of persistent or intermittent cough with purulent sputum, repeated low respiratory infection and abnormal chest radiograph were correlated to bronchiectasis by chest CT scan. We conclude, that there is a significant occurrence of bronchiectasis in patients with HIV infections and pulmonary disease, thus increasing morbidity and mortality in these patients and being the cause of repeated hospitalisations due to bacterial respiratory infections.
ABSTRACT
Se presentan 12 pacientes portadores de enfermedad de Chagas-Mazza tratados con benznidazol a razon de 5 mg/kg/dia, que presentan manifestaciones dermatologicas adversas. 5 de ellos eran de sexo femenino y 7 sexo masculino, con edades comprendidas entre los 31 y 50 anos. Las alteraciones dermatologicas observadas fueron:exantema morbiliforme (9 pacientes); lesiones purpuricas (3 pacientes); lesiones vesiculosas (3 pacientes); lesiones pustulosas (2 pacientes); descamacion furfuracea (1 paciente); edema (1 paciente). En los estudios histopatologicos de todos los pacientes se hallo un infiltrado linfocitario perivascular dermico. En 3 de los pacientes se observo, ademas, leve extravasacion eritrocitaria (purpura) en derredor de vasos alterados. La inmunofluorescencia de los casos estudados no revelo alteraciones
Subject(s)
Adult , Middle Aged , Humans , Male , Female , Chagas Disease , Nitroimidazoles , Skin ManifestationsABSTRACT
Se presentan 12 pacientes portadores de enfermedad de Chagas-Mazza tratados con benznidazol a razon de 5 mg/kg/dia, que presentan manifestaciones dermatologicas adversas. 5 de ellos eran de sexo femenino y 7 sexo masculino, con edades comprendidas entre los 31 y 50 anos. Las alteraciones dermatologicas observadas fueron:exantema morbiliforme (9 pacientes); lesiones purpuricas (3 pacientes); lesiones vesiculosas (3 pacientes); lesiones pustulosas (2 pacientes); descamacion furfuracea (1 paciente); edema (1 paciente). En los estudios histopatologicos de todos los pacientes se hallo un infiltrado linfocitario perivascular dermico. En 3 de los pacientes se observo, ademas, leve extravasacion eritrocitaria (purpura) en derredor de vasos alterados. La inmunofluorescencia de los casos estudados no revelo alteraciones
