Etiology of spontaneous pneumothorax in 105 HIV-infected patients without highly active antiretroviral therapy.
BACKGROUND
Spontaneous pneumothorax (SP) is a frequent complication in non-treated HIV-infected patients as a complication of opportunistic infections and tumours.


OBJECTIVE
To analyse the aetiology of SP in non-treated HIV patients.


METHODS
Observational study of SP cases observed in a cohort of 9831 of non-treated HIV-infected patients attended in seven Spanish hospitals.


RESULTS
105 patients (1.06%) developed SP. The aetiological cause was identified in 89 patients. The major causes identified were: bacterial pneumonia (36 subjects, 34.3%); Pneumocystis jiroveci pneumonia (PJP) (31 patients, 29.5%); and pulmonary tuberculosis (17 cases, 15.2%). The most common cause of SP in drugs users was bacterial pneumonia (40%), whereas PJP was more common (65%) in sexual transmitted HIV-patients. The most common cause of bilateral SP was PJP (62.5%) whereas unilateral SP was most commonly associated with bacterial pneumonia (40.2%). The most common cause of SP in patients with a CD4+ lymphocyte count >200 cells/ml and in patients without AIDS criteria was bacterial pneumonia. PJP was the more common cause in patients with a CD4+ lymphocyte count <200 cells/ml or with AIDS.


CONCLUSIONS
The incidence of SP in non-treated HIV-infected patients was 1.06%. The aetiology was related to the patients risk practices and to their degree of immunosuppression. Bacterial pneumonia was the most common cause of SP.
Rivero
Antonio
A
Reina Sofía University Hospital, Cordoba, Spain. ariveror@saludalia.com
Perez-Camacho
Inés
I
Lozano
Fernando
F
Santos
Jesús
J
Camacho
Angela
A
Serrano
Ascención
A
Cordero
Elisa
E
Jiménez
Francisco
F
Torres-Tortosa
Manuel
M
Torre-Cisneros
Julián
J
D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data; D015984:Causality; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D018410:Pneumonia, Bacterial / Q000453:epidemiology*; D011030:Pneumothorax / Q000453:epidemiology*; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D055815:Young Adult