PNEUMOTHORAX IN HIV-INFECTED PATIENTS - ROLE OF PNEUMOCYSTIS-CARINII PNEUMONIA AND PULMONARY TUBERCULOSIS

Patients with acquired immune deficiency syndrome (AIDS) are at increa sed risk for pneumothorax, which usually occurs in the setting of Pneu mocystis carinii pneumonia, The rationale of the present study was bas ed on the hypothesis that the increased incidence of pulmonary tubercu losis in human immunodeficiency virus (HIV)-infected patients could fa vour the development of pneumothorax in such patients, A case-control study was performed comprising 140 HIV-infefted patients grouped as fo llows: 35 patients with pneumothorax and 105 matched controls without pneumothorax. Univariate analysis Identified four risk factors for pne umothorax: 1) previous P, carinii pneumonia (p=0.01); 2) current P, ca rinii pneumonia (p=0,02); 3) pulmonary tuberculosis (p=0.01); and 4) c ysts, pneumatoceles or bullae an chest radiographs (p<0,001). Multivar iate analysis indicated that current P, carinii pneumonia (p=0,01) and pulmonary tuberculosis (p=0.04) were both independent risk factors fo r pneumothorax, In conclusion, our findings demonstrate that, in addit ion to Pneumocystis carinii pneumonia, pulmonary tuberculosis enhances the risk of pneumothorax in patients with acquired immune deficiency syndrome.