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.
Reina Sofía University Hospital, Cordoba, Spain. ariveror@saludalia.com
Antonio
A
Rivero
Inés
I
Perez-Camacho
Fernando
F
Lozano
Jesús
J
Santos
Angela
A
Camacho
Ascención
A
Serrano
Elisa
E
Cordero
Francisco
F
Jiménez
Manuel
M
Torres-Tortosa
Julián
J
Torre-Cisneros
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