Mycobacterial diseases and HIV infection.

OBJECTIVES

Evaluation of the incidence of mycobacterial diseases in patients infected with human immunodeficiency virus (HIV) and analysis of survival after diagnosis of mycobacteriosis.

METHODS

Retrospective analysis of clinical and laboratory data of HIV-infected patients admitted in our hospital from January 1st, 1985 to March 31st, 1992.

RESULTS

We observed 82 infections in 81 patients with an increase in the annual percentage from 2.2% to 6.4%. M. tuberculosis more than atypical Mycobacteria was found in patients with pulmonary infection (p = 0.03). Forty patients had a previous diagnosis of acquired immunodeficiency syndrome (AIDS) and 24 evolved in AIDS because of mycobacterial infection. We observed infection due to M. tuberculosis in patients with advanced HIV-infection (20/27 patients with tuberculosis had CD4+ cell count < 200/cm3). Mean survival after diagnosis and treatment was 329 days with better survival in patients with CD4+ cell count > 200/cm3 (p = 0.03). We did not find a statistically significant difference in survival between patients with tuberculosis and other mycobacteriosis.

CONCLUSIONS

Mycobacterial infections are increasing in HIV-infected patients, and tuberculosis is observed also in patients with advanced immunodeficiency. Survival is influenced by the severity of immunodeficiency more than by the mycobacterial species.