       Document 0580
 DOCN  M9640580
 TI    Pulmonary complications of HIV disease: 10 year retrospective evaluation
       of yields from bronchoalveolar lavage, 1983-93.
 DT    9604
 AU    Taylor IK; Coker RJ; Clarke J; Moss FM; Nieman R; Evans DJ; Veale D;
       Shaw RJ; Robinson DS; Mitchell DM; Department of Respiratory Medicine,
       St Mary's Hospital Medical; School, London, UK.
 SO    Thorax. 1995 Dec;50(12):1240-5. Unique Identifier : AIDSLINE
       MED/96138474
 AB    BACKGROUND--Pulmonary disease is a major contributor to morbidity and
       mortality in patients with HIV infection and AIDS. The aim of this study
       was to describe bronchoscopic findings and the spectrum of pulmonary
       pathogens in HIV seropositive patients undergoing investigation of
       respiratory disease over a 10 year period in a major UK referral centre.
       METHODS--Recruitment was procedure based with data being captured when
       bronchoscopy was clinically indicated. Data were evaluated from 580 HIV
       seropositive patients (559 men, age 13-65 years) over a 10 year period
       from June 1983 to March 1993. RESULTS--A total of 947 bronchoscopies was
       performed. The most frequent pulmonary pathogen isolated from
       bronchoalveolar lavage (BAL) fluid in 44% of all bronchoscopies was
       Pneumocystis carinii. Of all patients studied, 324 (55%) had at least
       one cytologically confirmed episode of P carinii pneumonia; this was
       AIDS defining in 219 (38%) of patients who underwent bronchoscopy.
       Between 1987 and 1993 the overall diagnostic yield from BAL fluid was
       76%; 25% of all bronchoscopies yielded positive microbiological results,
       the most frequent isolates being Staphylococcus aureus, Streptococcus
       pneumoniae, Pseudomonas spp, and Haemophilus influenzae. Mycobacteria
       were identified in 8% of patients; M tuberculosis was the most common
       being identified in 3% of lavage samples and in 4% of patients. No
       drug-resistant M tuberculosis was found. Viral isolates (mainly
       cytomegalovirus) were identified in up to 31% of BAL fluid samples.
       Endobronchial Kaposi's sarcoma was seen in 15% of patients at
       bronchoscopy. CONCLUSIONS--Of the 1956 newly diagnosed HIV seropositive
       patients receiving clinical care at St Mary's Hospital over this period,
       approximately 30% underwent bronchoscopy. Diagnostic rates for P carinii
       pneumonia, endobronchial Kaposi's sarcoma, and bacterial and
       mycobacterial infection have remained largely constant since 1989.
       Bronchoalveolar lavage produces high diagnostic yields generally, and P
       carinii pneumonia remains a common cause of pulmonary disease in these
       patients.
 DE    Adolescence  Adult  Aged  Bronchial Neoplasms/COMPLICATIONS
       *Bronchoalveolar Lavage Fluid/MICROBIOLOGY  Bronchoscopy
       Cytomegalovirus Infections/COMPLICATIONS  Female  Haemophilus
       Infections/COMPLICATIONS  Human  HIV Infections/*COMPLICATIONS  Lung
       Diseases/COMPLICATIONS/*MICROBIOLOGY  Male  Middle Age  Pneumococcal
       Infections/COMPLICATIONS  Pneumonia, Pneumocystis carinii/COMPLICATIONS
       Pneumonia, Staphylococcal/COMPLICATIONS  Pseudomonas
       Infections/COMPLICATIONS  Retrospective Studies  Sarcoma,
       Kaposi's/COMPLICATIONS  Tracheal Neoplasms/COMPLICATIONS  Tuberculosis,
       Pulmonary/COMPLICATIONS  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

