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  • Title: Etiology of spontaneous pneumothorax in 105 HIV-infected patients without highly active antiretroviral therapy.
    Author: Rivero A, Perez-Camacho I, Lozano F, Santos J, Camacho A, Serrano A, Cordero E, Jiménez F, Torres-Tortosa M, Torre-Cisneros J, Andalusian Group for the Study of Infectious Diseases (GAEI).
    Journal: Eur J Radiol; 2009 Aug; 71(2):264-8. PubMed ID: 18565710.
    Abstract:
    INTRODUCTION: Spontaneous pneumothorax (SP) is a frequent complication in non-treated HIV-infected patients as a complication of opportunistic infections and tumours. OBJECTIVE: To analyse the aetiology of SP in non-treated HIV patients. PATIENTS AND METHODS: Observational study of SP cases observed in a cohort of 9831 of non-treated HIV-infected patients attended in seven Spanish hospitals. RESULTS: 105 patients (1.06%) developed SP. The aetiological cause was identified in 89 patients. The major causes identified were: bacterial pneumonia (36 subjects, 34.3%); Pneumocystis jiroveci pneumonia (PJP) (31 patients, 29.5%); and pulmonary tuberculosis (17 cases, 15.2%). The most common cause of SP in drugs users was bacterial pneumonia (40%), whereas PJP was more common (65%) in sexual transmitted HIV-patients. The most common cause of bilateral SP was PJP (62.5%) whereas unilateral SP was most commonly associated with bacterial pneumonia (40.2%). The most common cause of SP in patients with a CD4+ lymphocyte count >200 cells/ml and in patients without AIDS criteria was bacterial pneumonia. PJP was the more common cause in patients with a CD4+ lymphocyte count <200 cells/ml or with AIDS. CONCLUSION: The incidence of SP in non-treated HIV-infected patients was 1.06%. The aetiology was related to the patients risk practices and to their degree of immunosuppression. Bacterial pneumonia was the most common cause of SP.
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