title: Mycological Profile of Sputum of HIV Positive Patients with Lower Respiratory Tract Infection and its Correlation with CD4+ T Lymphocyte Count.
abstract: BACKGROUND
  Fungal respiratory infections are important cause of mortality and morbidity among HIV positive individuals. They account for up to 70% of illness in Acquired Immunodeficiency Disease Syndrome cases (AIDS). The range of illness varies from asymptomatic mucosal candidiasis to overwhelming disseminated infections. In these patients dissemination of fungus leads to very serious outcomes hence, it is important to have the knowledge of prevailing profile of fungus causing infections, so that it can be treated at the onset. Low CD4+ T lymphocyte count is an excellent indicator of decreased immunity and can also be helpful to predict opportunistic fungal respiratory infections and other complications.
  
  
  OBJECTIVE
  To define the fungal aetiology of lower respiratory tract infections in HIV positive patients and to correlate the occurrence of different fungi with CD4+ T lymphocyte count.
  
  
  METHODS
  This was a cross sectional study conducted between May 2014 to April 2015, on 180 treatment naive HIV seropositive patients with lower respiratory tract infections attending the Integrated Counselling and Testing Centre, SMS Medical College, Jaipur, Rajasthan. Early morning expectorated and induced sputum samples were collected and processed for isolation and identification of fungal species. CD4+ T lymphocyte count estimation was done by BD FACS Calibur.
  
  
  RESULTS
  Fungal species were isolated from 155 (86.1%) patients. The most common isolate wasCandida albicans(31.7%), followed byAspergillus niger(17.7%) andAspergillus flavus(10%). The fungal species were most commonly isolated from patients with CD4+ T lymphocyte cell less than 200 cells/μl.
  
  
  CONCLUSIONS
  Fungal infections were seen in 86.1% of HIV positive patients with lower respiratory tract infections hence, high level of clinical suspicion for fungal aetiology of respiratory infections in HIV positive patients should be kept in mind.
authors: Resident, Department of Microbiology, S.M.S. Medical College , Jaipur, Rajasthan, India .
authors: Jyotsna
authors: J
authors: Chandwani
authors: Senior Professor, Department of Microbiology, S.M.S. Medical College , Jaipur, Rajasthan, India .
authors: Nitya
authors: N
authors: Vyas
authors: Professor, Department of Microbiology, S.M.S. Medical College , Jaipur, Rajasthan, India .
authors: Saroj
authors: S
authors: Hooja
authors: Assistant Professor, Department of Microbiology, S.M.S. Medical College , Jaipur, Rajasthan, India .
authors: Babita
authors: B
authors: Sharma
authors: Senior Professor & Head, Department of Microbiology, S.M.S. Medical College , Jaipur, Rajasthan, India .
authors: Rakesh
authors: R
authors: Maheshwari
keywords: AIDS; Aspergillus; Candida; Immunocompromised