Mycobacterial and nonbacterial pulmonary complications in hospitalized patients with human immunodeficiency virus infection: A prospective, cohort study

<p>Abstract</p> <p>Background</p> <p>A prospective observational study was done to describe nonbacterial pulmonary complications in hospitalized patients with human immunodeficiency virus (HIV) infection.</p> <p>Methods</p> <p>The study included 1,225 consecutive hospital admissions of 599 HIV-infected patients treated from April 1995 through March 1998. Data included demographics, risk factors for HIV infection, Acute Physiology and Chronic Health Evaluation (APACHE) II score, pulmonary complications, CD4⁺ lymphocyte count, hospital stay and case-fatality rate.</p> <p>Results</p> <p>Patient age (mean ± SD) was 38.2 ± 8.9 years, 62% were men, and 84% were African American. The median APACHE II score was 14, and median CD4⁺ lymphocyte count was 60/μL. Pulmonary complications were <it>Pneumocystis carinii</it> pneumonia (85) in 78 patients, <it>Mycobacterium avium</it> complex (51) in 38, <it>Mycobacterium tuberculosis</it> (40) in 35, <it>Mycobacterium gordonae</it> (11) in 11, <it>Mycobacterium kansasii</it> (10) in 9, <it>Cytomegalovirus</it> (10) in 10, <it>Nocardia asteroides</it> (3) in 3, fungus ball (2) in 2, respiratory syncytial virus (1), herpes simplex virus (1), <it>Histoplasma capsulatum</it> (1), lymphoma (3) in 3, bronchogenic carcinoma (2) in 2, and Kaposi sarcoma (1). The case-fatality rate of patients was 11% with <it>Pneumocystis carinii</it> pneumonia; 5%, <it>Mycobacterium tuberculosis</it>; 6%, <it>Mycobacterium avium</it> complex; and 7%, noninfectious pulmonary complications.</p> <p>Conclusion</p> <p>Most pulmonary complications in hospitalized patients with HIV are from <it>Pneumocystis</it> and mycobacterial infection.</p