A STUDY OF CHEST INFECTIONS IN HIV-SEROPOSITIVE PATIENTS IN KUALA-LUMPUR

A retrospective study of 144 adults with HIV infection was conducted t o investigate the prevalence of upper and lower respiratory tract infe ctions (URTls and LRTls). The patients were divided into two groups: t hose with acquired HIV through intravenous drug abuse (IVDA), and thos e who had acquired HIV through 'other' risk behaviours. LRTls were mor e prevalent than URTls overall, and LRTls were significantly more comm on (p<0.001) in IVDAs than in the other-risk group. Tuberculosis (40%) and bacterial pneumonias (33%) comprised the majority of LRTls among IVDAs, while Pneumocystis carinii pneumonia (40%) was the commonest LR Tl in the other-risk group. Analysis of CD4 T-lymphocyte counts indica ted that HIV-seropositive IVDAs are at greater risk of developing ches t infections at higher CD4 counts than other-risk patients. The IVDAs were also found to have a much higher rate of co-infection with hepati tis C and B, which may be a factor accelerating the progression from H IV infection to AIDS. The mean time averaged for the two groups from k nown seroconversion to development of respiratory tract infection is o nly 1.37 years, which suggests HIV-infected patients are presenting la te for treatment in Malaysia.