HIV-related pulmonary manifestations among Egyptian patients

Context
After description of the new first case of AIDS in 1981, the HIV pandemic expanded very rapidly to become a great global public health problem with wide health, economic, social, and developmental consequences that have not been seen with any other disease. Globally, there have been gains across the HIV testing and treatment cascade. The greatest contributor to the illness and deaths in persons infected with HIV is pulmonary disease.


Aims
The aim was to study the pattern of respiratory manifestations in HIV-infected patients among a sample of Egyptians.


Settings and design
A prospective, observational study.


Patients and methods
This study recruited 121 HIV patients with respiratory system involvement admitted to Abbassia Fever Hospital or Abbassia Chest Hospitals between December 2017 and March 2020. Clinical assessment included demographic data, history of chest symptoms, and comorbidities and local and general examination. Chest imaging was requested/reviewed, and procedures were performed as required. Laboratory assessment included CD4 count, and microbiological examinations of sputum and pleural fluid if found.


Statistical analysis used
SPSS program (Statistical Package for the Social Sciences) software, version 18.0.


Results
Of the participants 62 % have been receiving or previously received antiretroviral treatment. Cough was the most frequent symptom in 91.7%. Pleural collection was the most frequent radiological finding on chest radiology in 23% of patients. Tuberculosis was commonly a concomitant infection in 29.7% of patients. CD4 count ranged from 16 to 450 cells/mm3. The diagnosis of PJP and multidrug resistance tuberculosis was highly significantly associated with low CD4 count (P<0.01).


Conclusion
HIV infection is associated with a wide range of respiratory manifestations with infectious complications representing the majority of them. Low CD4 count, receiving antiretroviral treatment, and the source of HIV infection (sexual or intravenous drug abuse) are documented as risk factors for respiratory involvement in HIV patients.