Role of bronchoalveolar lavage in predicting survival of patients with human immunodeficiency virus infection

被引:20
作者
Agostini, C
Adami, F
Poulter, LW
IsraelBiet, D
Costa, MFE
Cipriani, A
Sancetta, R
Lipman, MCI
Juvin, K
TelesAraujo, AD
Cadrobbi, P
Masarotto, G
Semenzato, G
机构
[1] UNIV PADUA,SCH MED,DIPARTIMENTO MED CLIN & SPERIMENTALE,I-35128 PADUA,ITALY
[2] ROYAL FREE HOSP,SCH MED,DEPT CLIN IMMUNOL,LONDON,ENGLAND
[3] UNIV NOVA LISBOA,SCH MED,HOSP SANTA MARIA,P-1200 LISBON,PORTUGAL
[4] PADUA HOSP,DIV PNEUMOPHTHYSIOL,PADUA,ITALY
[5] PADUA HOSP,DIV INFECT DIS,PADUA,ITALY
[6] UNIV PADUA,SCH STAT,DEPT STAT SCI,PADUA,ITALY
关键词
D O I
10.1164/ajrccm.156.5.9611109
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
In this multicenter study, we investigated the prognostic factors that influence the risk of death in patients with human immunodeficiency virus (HIV) infection. Clinical and laboratory indices obtained from 161 HIV-seropositive patients who underwent a detailed morphologic and immunophenotypic evaluation of bronchoalveolar lavage (BAL) and peripheral blood cell populations were retrospectively analyzed. In 155 patients, death occurred within the 48-mo follow-up (mean follow-up: 14.8 mo; range: 1 to 48 mo). In the univariate analysis, the patient's age (> 30 yr), HIV disease status, HIV transmission category, number of opportunistic pathogens isolated from the BAL, percentage of BAL neutrophils, and low number of BAL CD4 T cells were predictive of increased mortality. In contrast, the presence of an alveolitis or an increase in the numbers of alveolar macrophages and CD3 T cells was associated with a decreased mortality. In the multivariate analysis, significant independent predictors were age, risk factor for HIV, and presence of an alveolitis. Furthermore, patients with a low number of BAL CD4 T cells had a particularly poor prognosis while the CD4 T-cell count in the peripheral blood (< 50 cells/mm(3) in the majority of our patients) had a negligible effect on predicting survival. Our findings suggest the clinical utility of BAL analysis in patients infected with HIV.
引用
收藏
页码:1501 / 1507
页数:7
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