Objective: In view of the relevance of co-infection with tuberculosis and human immunodeficiency virus, this study was designed to determine tuberculosis prevalence and identify factors related to tuberculosis in patients residing in a region in which both infections are highly prevalent. Methods: All patients treated during 1999 at the HIV/AIDS Clinic of the Universidade Federal do Rio Grande (Rio Grande Federal University) University Hospital were evaluated retrospectively, from the time of human immunodeficiency virus diagnosis, in terms of the incidence of tuberculosis and its relationship to sociodemographic, behavioral and immunological factors. Results: The sample included 204 patients, and tuberculosis prevalence was found to be 27%. The multivariate analysis showed a significant correlation between the development of tuberculosis and being of African descent (odds ratio: 4.76; 95% confidence interval: 1.93-11.72) and an inverse correlation between the development of tuberculosis and the TCD4+ lymphocyte count at the time of human immunodeficiency virus diagnosis (odds ratio: 0.995; 95% confidence interval: 0.993-0.997). When analyzed separately, other variables were found to be potential risk factors: being of the male gender (odds ratio: 2.49; 95% confidence interval: 1.15-5.39); and using illicit drugs (odds ratio: 2.1; 95% confidence interval: 1.02-4.31). Conclusion: The factors responsible for the development of tuberculosis among patients who are human immunodeficiency virus seropositive include immunological, socioeconomic and demographic factors. The high rate of tuberculosis prevalence among the seropositive patients underscores the urgent need to implement strategies that combine rapid identification and prompt treatment of individuals with active or latent infection, as well as of those with whom they have been in contact.

Keywords: HIV Infections/complications; AIDS-related opportunistic infections/complications; Tuberculosis/etiology; Tuberculosis/epidemiology

Bronchoalveolar lavage versus transbronchial biopsy in patients infected with the human immunodeficiency virus: comparative analysis of 287 examinations

Lavado broncoalveolar "versus" biópsia transbrônquica em pacientes HIV-positivos: análise comparativa de 287 exames

Ricardo H. Bammann, Angelo Fernandez, Carla M.P. Vázquez, Altamiro R. Dias

J Bras Pneumol.1998;24(3):112-118

A total of 287 bronchoscopies were performed in 267 patients infected with the human immunodeficiency virus (HIV). Bronchoalveolar lavage (BAL) and transbronchial biopsies (TBB) were sequentially performed in the same lung, in all cases. Specimens were examined after routine laboratory procedures for microbiologic and histologic analysis. Age ranged from 16 to 78 (median 37.2); 228 were men (85.4%) and 39 were women. Dyspnea was the main symptom in 198 cases (69.0%) and interstitial infiltrates (diffuse or localized) were the most common findings at chest radiographs (179 patients, 62.4%). Endoscopic view was normal in 246 patients (85.7%). Mucosal lesions suggestive of Kaposi's sarcoma (KS) were visible in 12 cases (4.2%). BAL detected 97 infectious agents, simultaneous co-infection occurred in 3 cases. TBB identified 165 pathogens (9 of them in association), anticipating a better yield than BAL in the diagnosis of P. carinii (84 versus 51, respectively) and cytomegalovirus (35 v. 0). Biopsies were unique in establishing the appropriate diagnosis of extrabronchial cancer and describing inespecific pneumonitis. Altogether, a definite diagnosis was obtained by bronchoscopic examination (including endoscopic view, BAL and TBB) in 271 of 287 cases (94.4%). Infections were caused by P. carinii in 105 patients (36.6%), Mycobacterium sp in 40 (13.9%), cytomegalovirus in 35 (12.2%), C. neoformans in 13 (4.5%) etc. Malignancies (including KS) were found in 16 patients (5.6%). More than one pathologic process was present in 28 (9.8%). Nonspecific pneumonitis was diagnosed in 56 cases (19.5%) and normal lung in 20 (7.0%). Complications related to bronchoscopy were pneumothorax (8 patients, 2.8%), haemorrhage (8), thoracic pain (2) and distal pneumonia (2). Chest tubes were required in 4 patients, including one fatal case (mortality rate of 0.3%). Combining BAL and TBB results increases the diagnostic yield of bronchoscopy in AIDS, with a low complication rate. If both techniques are performed, a higher number of infectious agents and more multiple causes of pulmonary disease may be identified.

Keywords: Bronchoscopy/methods. Acquired Immunodeficiency Syndrome/complications. Opportunistic infections related to AIDS/diagnosis.

Tuberculin testing of individuals infected with the human immunodeficiency virus: relationship with peripheral T-cell counts and active tuberculosis

Teste tuberculínico em indivíduos com infecção pelo vírus da imunodeficiência humana: relação com número de linfócitos T periféricos e atividade tuberculosa

Lenice do Rosário de Souza, Marli Therezinha Gimenez Galvão, Jussara Marcondes Machado, Domingos Alves Meira, Karlla Cunhas

J Bras Pneumol.2006;32(5):438-443

Human immunodeficiency virus seroprevalence in patients with tuberculosis in the city of Londrina, in the state of Paraná, Brazil

Soroprevalência da infecção pelo vírus da imunodeficiência humana em pacientes com tuberculose, em Londrina, Paraná

Arilson Akira Morimoto, Ana Maria Bonametti, Helena Kaminami Monimoto, Tiemi Matsuo

J Bras Pneumol.2005;31(4):325-331

Co-infection with Mycobacterium tuberculosis and human immunodeficiency virus: an epidemiological analysis in the city of Taubaté, Brazil

Co-infecção por Mycobacterium tuberculosis e vírus da imunodeficiência humana: uma análise epidemiológica em Taubaté (SP)

Luiz Gustavo Miranda de Carvalho, Anabelli Zanchetta Buani, Maria Stella Amorim da Costa Zöllner, Alexandre Prado Scherma

J Bras Pneumol.2006;32(5):424-429

Respiratory syncytial virus infection in children during SARS-CoV-2 pandemic at a referral center in Rio de Janeiro, Brazil

Giuliana Pucarelli Lebreiro, Marianna Tavares Venceslau1, Maria Angélica Arpon Marandino Guimarães1, Thalita Fernandes Abreu2, Yarina Rangel2, Ana Cristina Cisne Frota2, Cristina Barroso Hofer1

J Bras Pneumol.2024;50(3):e20240072

Correlation between inflammatory mediators in the nasopharyngeal secretion and in the serum of children with lower respiratory tract infection caused by respiratory syncytial virus and disease severity

Correlação entre mediadores inflamatórios na secreção nasofaríngea e no soro de crianças com infecção do trato respiratório inferior por vírus sincicial respiratórioe a gravidade da doença

Renata Amato Vieira, Edna Maria de Albuquerque Diniz,Maria Esther Jurfest Rivero Ceccon

J Bras Pneumol.2010;36(1):59-66

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