Document 0372
 DOCN  M9590372
 TI    Chronic cough in HIV--a retrospective review.
 DT    9509
 AU    Hammett RJ; Pigott P; Department of HIV Medicine, Royal North Shore
       Hospital,; University of Sydney, St. Leonards, N.S.W.
 SO    Annu Conf Australas Soc HIV Med. 1994 Nov 3-6;6:118 (unnumbered
       abstract). Unique Identifier : AIDSLINE ASHM6/95291727
 AB    We present eleven HIV positive patients who were referred to our unit
       for investigation of chronic cough. The spectrum of diagnoses, the
       utility of investigations and the efficacy of treatment in the setting
       of the different conditions is discussed. All patients had cough and/or
       dyspnoea which had been present for at least 6 weeks, in the absence of
       Pneumocystis pneumonia or acute bacterial pneumonia. All patients were
       reviewed by a Respiratory physician. The results of CD4 counts, white
       cell counts(WCC), cytomegalovirus(CMV) serology, sputum cultures,
       spirometry, chest x-rays, computerised tomography, and bronchoscopy are
       presented. One patient was diagnosed with asthma, three patients had
       bronchiectasis, four had pulmonary Kaposi's sarcoma (KS) and three had
       evidence of bronchial inflammation and irritability without proven
       infection or malignancy. CD4 counts are reported for each of the
       patients. No patient was CMV IgM positive. All patients had a WCC < 7.0
       x 1000/ul. In the patients with asthma there was excellent improvement
       in symptoms and lung function testing after treatment with inhaled
       bronchodilators and steroids. In the bronchiectatics, there was
       persistent cough, dyspnoea and sputum production associated with chronic
       bacterial colonisation of the airways. There was little sustained
       improvement in symptoms or objective measures, despite treatment. The
       patients with presumed KS demonstrate the difficulty in confirming this
       diagnosis; however three of the four responded to systemic chemotherapy
       with improvement in symptoms and clearing of chest x-rays. This
       improvement, however was not sustained on cessation of therapy. There
       was also a distinct group of patients who had spirometric and
       bronchoscopic evidence of airway inflammation and irritability without a
       positive histamine challenge. These patients had sustained improvement
       in symptoms and spirometry with steroid therapy. This series of patients
       encapsulates a spectrum of respiratory disease in patients with HIV
       infection, highlighting a separate group of patients in whom steroids
       have a role in therapy.
 DE    AIDS-Related Opportunistic Infections/*DIAGNOSIS  Chronic Disease
       Cough/*ETIOLOGY  Diagnosis, Differential  Dyspnea/ETIOLOGY  Human  HIV
       Infections/*DIAGNOSIS  Respiratory Tract
       Diseases/COMPLICATIONS/DIAGNOSIS  Retrospective Studies  MEETING
       ABSTRACT

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