BACTERIAL PNEUMONIA IN HIV-INFECTED PATIENTS - A PROSPECTIVE-STUDY OF68 EPISODES

We collected clinical and microbiological observations, as well as fol low-up on human immunodeficiency virus (HIV)-infected patients with ba cterial pneumonia, and compared pneumococcal pneumonia in patients wit h and without HIV infection. Fifty five HIV-infected patients, who had had 68 episodes of bacterial pneumonia, were studied prospectively. T wenty one HIV-infected patients with pneumococcal pneumonia were compa red to 69 non-HIV-infected patients with pneumococcal pneumonia. Aetio logical diagnosis was established in 48 cases (71%). The most common c ausative agents were S. pneumoniae and H. influenzae. Sixty percent of episodes took place in asymptomatic carriers of HIV infection and 37% in acquired immune deficiency syndrome (AIDS) patients, Overall morta lity was 10%. Fifty five percent of patients with follow-up had recurr ent episodes. Bacteraemic pneumococcal pneumonia was more frequent in HIV- than in non-HIV-infected patients, and the mortality of pneumococ cal pneumonia was also higher in HIV- (19%) than in non-HIV-infected ( 4.3%) patients. We conclude that bacterial pneumonia is a frequent pro blem in HIV-infected patients and that recurrent episodes are common. The clinical presentation of pneumococcal pneumonia is generally indis tinguishable from that occurring in normal hosts, but bacteraemia is m ore common and the mortality is higher in HIV-infected patients.