The spectrum of chest infections in HIV positive patients in Edinburgh.
In a retrospective analysis of all known HIV-positive patients admitted to the City Hospital before November 1989, 208 patients accounted for 612 admissions, 72% being injection drug users (IDUs). One hundred and eighty admissions (29%) were for chest-related disorders, and this was the commonest reason for admission. Unlike other U.K. centres where more than 50% chest problems are due to Pneumocystis carinii pneumonia (PCP), only 27% of our chest admissions were for PCP. Fifty-four percent of chest admissions were for bacterial chest infections (BCIs), the commonest organism isolated being Haemophilus influenzae. Despite the fact that most (50/97) of these admissions were in patients with 'asymptomatic' HIV disease (CDC classification 2 and 3), 50% had radiological pneumonia, 43% were hypoxic, 28% were hypercapnic and the average duration of hospitalisation was 10 days. BCIs were more common in HIV-positive IDUs when compared with HIV-negative IDUs, other HIV-positive patients and the general age-matched population. Medical provision for IDU-related HIV disease should take into account the high rate of BCIs and of hospital admissions in patients who do not yet have CDC stage 4 disease.
Willocks
L
L
Regional Infectious Diseases Unit, City Hospital, Edinburgh, Scotland, U.K.
Cowan
F
F
Brettle
R P
RP
Emmanuel
F X
FX
Flegg
P J
PJ
Burns
S
S
D005260:Female; D006679:HIV Seropositivity / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D007902:Length of Stay; D008171:Lung Diseases / Q000453:epidemiology* / Q000382:microbiology; D008297:Male; D009894:Opportunistic Infections / Q000453:epidemiology* / Q000382:microbiology; D010343:Patient Admission / Q000706:statistics & numerical data; D011020:Pneumonia, Pneumocystis / Q000453:epidemiology / Q000382:microbiology; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000382:microbiology; D012189:Retrospective Studies; D012606:Scotland / Q000453:epidemiology