RESEARCH PAPER
Clinical outcomes and complications of fiberoptic bronchoscopy in HIV-infected patients
1
Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
2
Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
3
Virology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
4
Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
Submission date: 2020-05-03
Acceptance date: 2020-05-17
Publication date: 2020-10-09
HIV & AIDS Review 2020;19(3):172-179
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Respiratory diseases, including infectious and non-infectious complications are common among patients with human immunodeficiency virus (HIV) infection. We aimed to determine the performance of fiberoptic bronchoscopy (FOB), bronchoalveolar lavage, and transbronchial lung biopsy in HIV-infected patients.
Material and methods:
The current retrospective study was performed in Masih Daneshvari Hospital, Tehran, Iran, from January 2003 to March 2017. Patients with HIV infection and 836 episodes of respiratory manifestations were selected. Indications, outcomes as well as results and complications of bronchoscopy were extracted. Performance of bronchoscopy to determine definite etiology and its ability to rule out other differential diagnoses were evaluated.
Results:
The indications of FOB were found in 289 subjects (34.6%) with respiratory diseases, of whom only 220 patients had undergone the procedure. Bronchoscopy confirming a final diagnosis was found in 87 (39.5%) patients and a diagnostic benefit was noted for minimum 66.7% of the subjects. Diagnostic ability of bronchoscopy was higher in patients suspected of pneumocystis jiroveci pneumonia (PJP), tuberculosis (TB), cytomegalovirus (CMV) pneumonitis, and in cases with ground-glass opacity and diffuse lung infiltrates (p-value: 0.003 and 0.035, respectively), and lower for subjects demonstrating reticulonodular infiltrations and right middle and lower lobes involvement (p-value: 0.008, 0.005, and 0.045, respectively). Procedure-related complications were reported in five subjects.
Conclusions:
FOB is a significantly advantageous and safe procedure in HIV-infected patients. Its diagnostic yield is higher in patients with ground-glass opacity and diffuse infiltration in chest computed tomography scan.
Respiratory diseases, including infectious and non-infectious complications are common among patients with human immunodeficiency virus (HIV) infection. We aimed to determine the performance of fiberoptic bronchoscopy (FOB), bronchoalveolar lavage, and transbronchial lung biopsy in HIV-infected patients.
Material and methods:
The current retrospective study was performed in Masih Daneshvari Hospital, Tehran, Iran, from January 2003 to March 2017. Patients with HIV infection and 836 episodes of respiratory manifestations were selected. Indications, outcomes as well as results and complications of bronchoscopy were extracted. Performance of bronchoscopy to determine definite etiology and its ability to rule out other differential diagnoses were evaluated.
Results:
The indications of FOB were found in 289 subjects (34.6%) with respiratory diseases, of whom only 220 patients had undergone the procedure. Bronchoscopy confirming a final diagnosis was found in 87 (39.5%) patients and a diagnostic benefit was noted for minimum 66.7% of the subjects. Diagnostic ability of bronchoscopy was higher in patients suspected of pneumocystis jiroveci pneumonia (PJP), tuberculosis (TB), cytomegalovirus (CMV) pneumonitis, and in cases with ground-glass opacity and diffuse lung infiltrates (p-value: 0.003 and 0.035, respectively), and lower for subjects demonstrating reticulonodular infiltrations and right middle and lower lobes involvement (p-value: 0.008, 0.005, and 0.045, respectively). Procedure-related complications were reported in five subjects.
Conclusions:
FOB is a significantly advantageous and safe procedure in HIV-infected patients. Its diagnostic yield is higher in patients with ground-glass opacity and diffuse infiltration in chest computed tomography scan.
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