Alteraciones pulmonares en el paciente VIH/sida: aspectos clínico-diagnósticos y de respuesta terapéutica

introduction: hiv/aids patients with respiratory manifestations and/or pulmonary infiltrates show similar clinical and radiological features, that is the reason why making a causative diagnosis becomes sometimes difficult. objective: to describe the main manifestations and pulmonary conditions, to identify the germs isolated from sputum samples, and to determine the response to treatment according to the host's conditioning factors. methods: it was decided to perform an observational, cross sectional study on 83 hiv/aids patients with respiratory symptoms admitted to "pedro kourí" institute of tropical medicine from december 2005 to june 2006. summary measures were used for both quantitative and qualitative analyses, as well as statistical tests such as independence, homogeneity, mean comparisons and mann whitney. results: the most frequent respiratory manifestations were cough (97.6 %), fever (93.9 %), and expectoration (68.7 %). predominant radiological findings were the inflammatory broncho-pneumonic and pneumological lesions (10.8 % and 9.6 % respectively). the etiological agents most frequently isolated from sputum were candida albicans, pseudomonas aeruginosa and rhodococcus equi. the unfavourable response to antibiotic treatment was associated to factors such as: cd4 count below 200 cell/mm3, viral load higher than 50 000 copies/ml3, antiretroviral therapy withdrawal, anemia, and accelerated globular sedimentation rate. conclusions: this study demonstrated that the inflammatory lesions are an important cause of morbidity among hiv/aids patients with respiratory symptoms in cuba, along with the existence of several conditioning factors that unfavourably affect the therapeutic response.