RT Journal Article
SR Electronic
T1 Bronchoscopy in the HIV era – 66 months in review
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA770
DO 10.1183/13993003.congress-2016.PA770
VO 48
IS suppl 60
A1 Maria Antónia Glória Galego
A1 Catarina Oliveira Paulo
A1 Daniela Rodrigues
A1 Sofia Jordão
A1 Joana Amado
A1 Isabel Neves
A1 Jorge Ferreira
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/PA770.abstract
AB Respiratory disease is a common complication of HIV infection and the precise diagnosis can be elusive without invasive studies. A retrospective analysis was made of all bronchoscopies (BC) performed on HIV patients between June 2010 and December 2015, at a local hospital.82 exams were made relating to 73 patients (79.5% were men; mean age 46.8 years ± 12.1), 21 patients were newly diagnosed with HIV during investigation. In 60 episodes of disease, a stage 3 CDC cell count classification was found, 67% of which had less than 50 CD4+/µL. Among the 74% with previously known HIV diagnosis, 47% had abandoned antiretroviral therapy (ART) and 21% hadn't achieved viral suppression under ART yet. 71 BC were performed during hospitalization – 33,3% of patients had intensive/intermediate care unit admissions and 43,5% needed invasive ventilation support. The mean time between admission and bronchoscopy was 6,5 days and suspicion of tuberculosis or pneumocystosis were the most common reasons. Pneumocyistis jirovecii infection (PJP) was found in 20,6% (2 cases by lavage cytology only) and pulmonary tuberculosis in 11% (half with extra-pulmonary dissemination). 2 atypical mycobacteriosis (Mycobacterium kansasii and Mycobacterium avium complex) and 2 Cytomegalovirus pneumonitis (both associated with PJP) were also diagnosed by BC. Among the 8 neoplasms identified, 5 were through BC – 4 of pulmonary origin and 1 plasmablastic lymphoma. BC was diagnostic in 52% of episodes. In 20 of the non-diagnostic exams, patients were or had been under recent antibiotic therapy.There is a wide range of lung diseases in HIV patients that include infectious and non-infectious causes and BC is a valuable exam in the pursuit of a diagnosis in this population.