COMMUNITY-BASED RESPIRATORY VIRAL-INFECTIONS IN HIV-POSITIVE PATIENTSWITH LOWER RESPIRATORY-TRACT DISEASE - A PROSPECTIVE BRONCHOSCOPIC STUDY

Objectives: To evaluate the contribution of community-based respirator y virus infections to lower respiratory tract disease in HIV-1 infecte d individuals. Design: Prospective clinical cohort study. Setting: Spe cialist in-patient unit for HN and AIDS, University College London Hos pitals, London. Subjects: 44 consecutive HIV-1 antibody positive patie nts who underwent 47 diagnostic bronchoscopies for evaluation of the s ymptoms and signs of lower respiratory tract disease. Time: Winter mon ths of 1994/95. Main outcome measures: Detection, in bronchoscopic alv eolar lavage fluid, of infection with influenza A and B, respiratory s yncytial virus (RSV), parainfluenza 1, 2 and 3 (by immunofluorescence and cell culture) and adenovirus and enteroviruses (by cell culture). Results: No evidence of influenza, RSV, parainfluenza, adenovirus, or enterovirus infection was detected. Conclusions: Despite a marked incr ease in RSV and influenza B infection in the general population over t he winter of 1994-95, respiratory virus infections were not detected i n this cohort of HIV infected patients. As the organisms causing lower respiratory tract disease were related to immunosuppression, this stu dy questions the value of routine identification of community-based re spiratory viruses in this patient group.