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Titre du document / Document title

Respiratory disease trends in the pulmonary complications of HIV infection study cohort

Auteur(s) / Author(s)

The Pulmonary Complications of HIV Infection Study Group
WALLACE J. M. ; HANSEN N. I. ; LAVANGE L. ; GLASSROTH J. ; BROWDY B. L. ; ROSEN M. J. ; KVALE P. A. ; MANGURA B. T. ; REICHMAN L. B. ; HOPEWELL P. C. ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

Department of Medicine, Olive View-UCLA Medical Center, Sylmar, California, ETATS-UNIS
Research Triangle Institute, Research Triangle Park, North Carolina, ETATS-UNIS
Northwestern University, Chicago, Illinois, ETATS-UNIS
University of California, Los Angeles, California, ETATS-UNIS
Beth Israel Medical Center, New York, New York, ETATS-UNIS
Henry Ford Hospital, Detroit, Michigan, ETATS-UNIS
University of Medicine and Dentistry, Newark, New Jersey, ETATS-UNIS
University of California, San Francisco, California, ETATS-UNIS

Résumé / Abstract

We examined trends in the incidence of specific respiratory disorders in a multicenter cohort with progressive human immunodeficiency virus (HIV) disease during a 5-yr period. Individuals with a wide range of HIV disease severity belonging to three transmission categories were evaluated at regular intervals and for episodic respiratory symptoms using standard diagnostic algorithms. Yearly incidence rates of respiratory diagnoses were assessed in the cohort as a whole and according to CD4 count or HIV transmission category. The most frequent respiratory disorders were upper respiratory tract infections, but the incidence of lower respiratory tract infections increased as CD4 counts declined. Specific lower respiratory infections followed distinctive patterns according to study-entry CD4 count and transmission category. Acute bronchitis was the predominant lower respiratory infection of cohort members with entry CD4 counts > 200 cells/mm3. In cohort members with entry CD4 counts of 200 to 499 cells/mm3, the incidence of bacterial and Pneumocystis carinii pneumonia each increased an average of 40% per year. In members with entry CD4 counts < 200 cells/mm3, acute bronchitis, bacterial pneumonia, and P. carinii pneumonia occurred at high rates without discernible time trends, despite chemoprophylaxis in more than 80% after Year 1, and the rate of other pulmonary opportunistic infections increased over time. Each year, injecting drug users had a higher incidence of bacterial pneumonia than did homosexual men. The yearly rate of tuberculosis was < 3 episodes/100 person-yr in each entry CD4 and HIV-transmission group. We conclude that the time trends of HIV-associated respiratory disorders are determined by HIV disease stage and influenced by transmission category. Whereas acute bronchitis is prevalent during all stages of HIV infection, incidence rates of bacterial pneumonia and P. carinii pneumonia rise continuously during progression to advanced disease. In advanced disease, the incidence of acute bronchitis, bacterial pneumonia and P. carinii pneumonia is high despite widespread chemoprophylaxis.

Revue / Journal Title

American journal of respiratory and critical care medicine    ISSN  1073-449X 

Source / Source

1997, vol. 155, no1, pp. 72-80 (31 ref.)

Langue / Language

Anglais

Editeur / Publisher

American Thoracic Society, New York, NY, ETATS-UNIS  (1994) (Revue)

Mots-clés anglais / English Keywords

AIDS

;

Pneumonia

;

Incidence

;

Complication

;

Follow up study

;

Human

;

Viral disease

;

Infection

;

Immunopathology

;

Immune deficiency

;

Lung disease

;

Bacteriosis

;

Parasitosis

;

Pneumocystis carinii

;

Sporozoa

;

Protozoa

;

Respiratory disease

;

Mots-clés français / French Keywords

SIDA

;

Pneumonie

;

Incidence

;

Complication

;

Etude longitudinale

;

Homme

;

Virose

;

Infection

;

Immunopathologie

;

Immunodéficit

;

Poumon pathologie

;

Bactériose

;

Parasitose

;

Pneumocystis carinii

;

Sporozoa

;

Protozoa

;

Appareil respiratoire pathologie

;

Mots-clés espagnols / Spanish Keywords

SIDA

;

Neumonía

;

Incidencia

;

Complicación

;

Estudio longitudinal

;

Hombre

;

Virosis

;

Infección

;

Inmunopatología

;

Inmunodeficiencia

;

Pulmón patología

;

Bacteriosis

;

Parasitosis

;

Pneumocystis carinii

;

Sporozoa

;

Protozoa

;

Aparato respiratorio patología

;

Localisation / Location

INIST-CNRS, Cote INIST : 2013, 35400006256953.0140

Nº notice refdoc (ud4) : 2549251



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