Clinical manifestations of pneumocystis pneumonia in isolated and concomitant lung injury in HIV-positive patients

Puzyreva L.V., Tolokh I.M., Konchenko V.D., Dalabaeva L.M., Dubrovska I.I., Didenko N.E., Druzenko A.V., Yanina O.A., Rudenko S.A., Bryukhanova N.S., Khlebova N.V., Lisichkina A.V., Zenkova L.A., Balabokhina M.V.

Omsk State Medical University of the Ministry of Health of Russia, Omsk
Infectious Clinical Hospital № 1 named after Dalmatov D.M., Omsk
Emergency Hospital № 2, Omsk
Clinical TB Dispensary № 4, Omsk
City Clinical Hospital № 11, Omsk
Center for the Prevention and Control of AIDS and Infectious Diseases, Omsk

In patients with HIV infection, lung diseases occur more often than other comorbidities. The aim of our study was to investigate and analyze the clinical manifestations of isolated pneumocystis pneumonia, as well concomitant with other lung diseases.

Materials and methods. An open prospective comparative study included 286 patients with HIV infection with clinical manifestations of pneumonia. According to the results of the examination, patients were divided into groups: isolated pneumocystis pneumonia (n=132), pneumocystosis and bacterial pneumonia (n=76), pneumocystis pneumonia and pulmonary tuberculosis (n=69), and a combination of pneumocystis pneumonia and cytomegalovirus pneumonia (n=9).

Research results. Most patients had secondary HIV-associated infectious diseases with a high viral load and low levels of CD4+ lymphocytes in the blood. Complaints were noted to be present in all patients, however, the duration of disease development, the intensity of the symptoms upon onset and the increase in respiratory failure varied. The data of general clinical laboratory and radiological examination were not extremely significant for the verification of pneumonia.

The lowest lethality rate was registered in the group of patients with isolated pneumocystis pneumonia, and the highest in the group of patients with concomitant lung disease.

Thus, in all patients with HIV infection with suspected respiratory diseases, it is necessary to perform the entire range of examinations with mandatory study of broncho-alveolar lavage.