Pulmonary co-morbidity in HIV-infected sputum AFB smear-negative Ugandan adults

Objectives: To determine the extend of comorbidity present in HIV positive and negative patients with respiratory tract infections.
Methods: Descriptive cross sectional study. Between October 2002 and December 2003 88 bronchoscopies were analysed at Mulago teaching hospital.
Results: 70.5% of the patients were HIV positive with a mean age of 35.1 years. In the HIV positive group, PKS was the most frequent diagnosis made (38.7%), followed by PCP (37.1%) and PTB (14.5%). In the HIV negative group, lung malignancy was the commonest diagnosis found. Ten of the HIV positive patients (16.1%) had two or more pulmonary diseases: two patients had both PCP and PTB, three patients had PKS and PTB, four patients had PKS and PCP, and one patient had PCP, PKS and PTB. When we analysed according to diseases, 30.4% (7/23) of PCP patients had other opportunistic diseases, PKS patients, 30.0% (8/24) and PTB patients, 66.7 % (6/9).
Conclusion: The presence of multiple infectious agents may explain why some HIV positive patients with respiratory disease show only temporary clinical improvement. This suggests that one diagnosis may not be enough for HIV patients.