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Pulmonary complications in intravenous drug users with and without human immunodeficiency virus co-infection

Karolina Klester, Elena Klester, Yakov Shoikhet, Alexander Zharikov
European Respiratory Journal 2019 54: PA3846; DOI: 10.1183/13993003.congress-2019.PA3846
Karolina Klester
1Altai State medical University, Barnaul, Russian Federation
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  • For correspondence: klesterk@bk.ru
Elena Klester
1Altai State medical University, Barnaul, Russian Federation
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Yakov Shoikhet
1Altai State medical University, Barnaul, Russian Federation
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Alexander Zharikov
1Altai State medical University, Barnaul, Russian Federation
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Abstract

Objective: to study features of pulmonary complications in intravenous drug users (IDUs) with and without HIV.

Materials and Methods: 149 patients (111 were males, mean age - 34,6±5,2 years)- IDUs diagnosed with pneumonia who were included in the study as they admitted to the hospital. HIV infection was verified in 112 (75%). 105 (70%) patients had viral hepatitis (B, C, B+C), 70 (47%) -tuberculosis.

Results: In the presence of HIV infection, especially with severe immunosuppression of CD4+ <30 cells/μl, clinical manifestations were febrile illness (89%), dyspnea (83%), pleuritic chest pain (68%), and symptoms of secondary diseases (candidiasis, lymphadenopathy, etc.). Chest CT showed multiple peripheral nodules in both lungs (n = 69), cavitation (n = 43), focal or wedge-shaped infiltrates (n = 38) and pleural effusion (n = 36). Methicillin-resistant Staphylococcus aureus (MRSA) (n = 34), methicillin-sensitive St. aureus (MSSA) (n = 22) and Candida (n = 16) has grown in blood cultures. HCV viremia was strongly related to HIV (OR, 6.262; 95% CI, 1.515-18.28), but negatively correlated to HBsAg seropositivity (OR, 0.161; 95% CI, 0.082-0.317). 41 patients died. In the absence of HIV in the clinical picture, bronchopulmonary manifestations were poorly expressed, the sepsis clinic prevailed.

Conclusion: pulmonary complications and secondary manifestations of HIV predominate in the clinic in HIV-infected IDUs. The current is characterized by an unfavorable prognosis. Appropriate antimicrobial therapy, control of the infectious source and resolution of the illness can be expected for most patients- IDUs with early diagnosis of pulmonary complications in the absence of HIV.

  • Immunosuppression
  • Sepsis
  • Comorbidities

Footnotes

Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA3846.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2019
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Pulmonary complications in intravenous drug users with and without human immunodeficiency virus co-infection
Karolina Klester, Elena Klester, Yakov Shoikhet, Alexander Zharikov
European Respiratory Journal Sep 2019, 54 (suppl 63) PA3846; DOI: 10.1183/13993003.congress-2019.PA3846

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Pulmonary complications in intravenous drug users with and without human immunodeficiency virus co-infection
Karolina Klester, Elena Klester, Yakov Shoikhet, Alexander Zharikov
European Respiratory Journal Sep 2019, 54 (suppl 63) PA3846; DOI: 10.1183/13993003.congress-2019.PA3846
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