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The clinical manifestation of pulmonary infection in AIDS patients

Authors
Jung, Jae WooChung, Jin WonSong, Ju HanJeon, Eun JuLee, Young WooChoi, Jae CheolShin, Jong WookPark, In WhonChoi, Byoung WhuiKim, Jae Yeol
Issue Date
Dec-2006
Publisher
Korean National Tuberculosis Association
Keywords
AIDS; HIV; Pulmonary infection
Citation
Tuberculosis and Respiratory Diseases, v.61, no.6, pp 554 - 561
Pages
8
Journal Title
Tuberculosis and Respiratory Diseases
Volume
61
Number
6
Start Page
554
End Page
561
URI
https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/25672
DOI
10.4046/trd.2006.61.6.554
ISSN
1738-3536
2005-6184
Abstract
Background: In AIDS patients, the respiratory tract is one of the most frequently involved site of by an opportunistic infection, and an even common, casual pulmonary infection manifests in a peculiar ways in AIDS patients. In Korea, because of the low prevalence of AIDS, there is insufficient data compared with other Southeast Asian counties. However, considering the sexual behavior of the younger generation, it is expected that it will not be long before AIDS becomes a major public health issue in Korea. This study examined the clinical manifestation of HIV positive people and AIDS patients. The pulmonary manifestion of HIV-positive was evaluated. This study focused on the differences in the clinical manifestation between AIDS patients with pulmonary disease and simple HIV positive people. The characteristics of common pulmonary infections in AIDS patients were also analyzed. Method: The medical records of 28 HIV positive patients who visited the hospital of ChungAng University Hospital from January, 2001 to February, 2006 were analyzed retrospectively. Result: Twenty-seven patients out of 28 HIV positive patients were male and the average age was 40.6(23-65). Patients in their thirties were most commonly affected. Elven patients had pulmonary diseases. Pulmonary tuberculosis (4 cases) and pneumocystis pneumonia (4 cases) were the most common respiratory infection. One patient showed a peculiar type of systemic cryptococcus. which was accompanied by lung and pleural dissemination. The CD4+lymphocyte count of patients with a pulmonary infection was significantly lower in patients with a pulmonary manifestation than those with only a HIV infection (79.5/mm 3 vs 400/mm 3, respectively)(p<.05). Patients with pulmonary disease were in a more severe immunosuppressive state. There were 4 patients with pulmonary tuberculosis, 4 with pneumocystis pneumonia, 4 with secondary syphilis, 2 with primary syphilis, and 2 with HZV infection. The average CD4 lymphocyte counts was 56/mm 3 in those with pulmonary tuberculosis, 42/mm 3 in those with pneumocystis pneumonia, and 455/mm 3 in those with secondary syphilis. Conclusion: This study examined the clinical manifestation of HIV positive patients, particularly AIDS patients with pulmonary disease, A more severe immunosuppressive status was observed in HIV-related pulmonary compared with those with HIV-related extrapulmonary disease, and the frequency of pulmonary tuberculosis in pulmonary disease was higher than expected. Respiratory infection in AIDS manifest in uncommon ways e.g. disseminated cryptococcosis involving the lung and pleura. Evidently, AIDS patients with a respiratory infection have a more severe form of immunosuppression than those with a simple HIV infection. As expected, patients with a pulmonary infection were in a more severe immunosuppressed state than those with a simple HIV infection. Opportunistic infections can show peculiar clinical presentations in AIDS patients.
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