TY - JOUR
T1 - Etiology of pulmonary complications of human immunodeficiency virus-1-infected patients in Taiwan in the era of combination antiretroviral therapy
T2 - A prospective observational study
AU - Lee, Kuan Yeh
AU - Ho, Chao Chi
AU - Ji, Dar Der
AU - Lee, Chang Min
AU - Tsai, Mao Song
AU - Cheng, Aristine C.
AU - Chen, Pao Yu
AU - Tsai, Shin Yen
AU - Tseng, Yu Tzu
AU - Sun, Hsin Yun
AU - Lee, Yi Chien
AU - Hung, Chien Ching
AU - Chang, Shan Chwen
PY - 2013/12
Y1 - 2013/12
N2 - Objectives: We aimed to investigate the etiology of pulmonary complications of human immunodeficiency virus-(HIV)-1-infected patients in Taiwan in the era of combination antiretroviral therapy (cART). Methods: From July 2009 to March 2012, a prospective observational study was conducted to identify the etiology of pulmonary complications in HIV-1-infected patients who sought HIV care at a university hospital in Taiwan. A stepwise diagnostic approach was adopted, which included radiography, serology, microbiology, bronchoscopy or video-assisted thoracoscopicsurgery, and polymerase chain reaction assays for cytomegalovirus and Pneumocystis jirovecii. Results: During the study period, a total of 203 episodes of pulmonary complications that occurred in 190 patients with a mean CD4 count of 123×106cells/L were analyzed. Thirty-eight episodes (18.7%) occurred in patients with a CD4 count >200×106cells/L, 71 (35.0%) between 50 and 200×106cells/L, and 94 (46.3%) <50×106cells/L. Pneumocystis pneumonia accounted for more than half of the complications in patients with a CD4 count <200×106cells/L. In patients with a CD4 count >200×106cells/L, the etiology of pulmonary complications was diverse, with bacterial infections (47.4%) being the most common, followed by tuberculosis (15.8%) and lung edema (13.2%). Pneumocystosis and cytomegalovirus pneumonitis were seen mostly or exclusively in patients with a CD4 count <200×106cells/L and were the leading causes of interstitial pneumonitis. On the other hand, empyema, legionellosis, and lung edema were more commonly seen in patients with a CD4 count >200×106cells/L. Conclusions: The etiology of pulmonary complications in HIV-1-infected patients was diverse and varied with the categories of CD4 counts. Pneumocystosis remained the leading cause of pulmonary complications in patients with lower CD4 counts in Taiwan in the cART era.
AB - Objectives: We aimed to investigate the etiology of pulmonary complications of human immunodeficiency virus-(HIV)-1-infected patients in Taiwan in the era of combination antiretroviral therapy (cART). Methods: From July 2009 to March 2012, a prospective observational study was conducted to identify the etiology of pulmonary complications in HIV-1-infected patients who sought HIV care at a university hospital in Taiwan. A stepwise diagnostic approach was adopted, which included radiography, serology, microbiology, bronchoscopy or video-assisted thoracoscopicsurgery, and polymerase chain reaction assays for cytomegalovirus and Pneumocystis jirovecii. Results: During the study period, a total of 203 episodes of pulmonary complications that occurred in 190 patients with a mean CD4 count of 123×106cells/L were analyzed. Thirty-eight episodes (18.7%) occurred in patients with a CD4 count >200×106cells/L, 71 (35.0%) between 50 and 200×106cells/L, and 94 (46.3%) <50×106cells/L. Pneumocystis pneumonia accounted for more than half of the complications in patients with a CD4 count <200×106cells/L. In patients with a CD4 count >200×106cells/L, the etiology of pulmonary complications was diverse, with bacterial infections (47.4%) being the most common, followed by tuberculosis (15.8%) and lung edema (13.2%). Pneumocystosis and cytomegalovirus pneumonitis were seen mostly or exclusively in patients with a CD4 count <200×106cells/L and were the leading causes of interstitial pneumonitis. On the other hand, empyema, legionellosis, and lung edema were more commonly seen in patients with a CD4 count >200×106cells/L. Conclusions: The etiology of pulmonary complications in HIV-1-infected patients was diverse and varied with the categories of CD4 counts. Pneumocystosis remained the leading cause of pulmonary complications in patients with lower CD4 counts in Taiwan in the cART era.
KW - Bacterial pneumonia
KW - Cytomegalovirus pneumonitis
KW - Interstitial pneumonitis
KW - Pneumocystis jirovecii pneumonia
KW - Pulmonary complication
KW - Tuberculosis
UR - http://www.scopus.com/inward/record.url?scp=84890126445&partnerID=8YFLogxK
U2 - 10.1016/j.jmii.2012.08.003
DO - 10.1016/j.jmii.2012.08.003
M3 - Article
C2 - 23026388
AN - SCOPUS:84890126445
SN - 1684-1182
VL - 46
SP - 433
EP - 440
JO - Journal of Microbiology, Immunology and Infection
JF - Journal of Microbiology, Immunology and Infection
IS - 6
ER -
