Bronchial responsiveness in AIDS patients with Pneumocystis carinii pneumonia.

Important note: Information in this article was accurate in 1993. The state of the art may have changed since the publication date.

Bronchial responsiveness in AIDS patients with Pneumocystis carinii pneumonia.

AIDS. 1992 Nov;6(11):1331-3. Unique Identifier : AIDSLINE MED/93112307
Ong EL; Hanley SP; Mandal BK; Regional Department of Infectious Diseases and Tropical Medicine,; Monsall Hospital, Manchester, England, UK.

Abstract: OBJECTIVE: To study bronchial responsiveness to inhaled histamine among HIV-infected patients. DESIGN: A prospective study in a regional infectious diseases unit. METHODS: Three groups of patients were studied. Group A consisted of AIDS patients (n = 7) who had had Pneumocystis carinii pneumonia (PCP), group B of AIDS patients (n = 7) not known to have had PCP, and group C of asymptomatic HIV-positive patients (n = 7). Inhalational histamine challenge in cumulative doses (0.03-3.91 mumol) was administered by a nebulizer. It was stopped when the forced expiratory volume in 1 sec (FEV1) had fallen by more than 20% of the baseline value or when the cumulative dose administered exceeded 3.91 mumol. Response was measured as percentage change in FEV1 from the baseline value, and plotted on a linear scale against log dose histamine to enable the dose of histamine causing a 20% fall in FEV1 (PD20-FEV1) to be determined. Statistical analysis was performed by analysis of variance. RESULTS: AIDS patients previously infected with PCP (group A) had a significantly lower PD20-FEV1 [(mean, 0.31 mumol; range, 0.07-0.95; s.d., 0.31; s.e., 0.12; 95% confidence interval (CI), 0.03-0.60)] than AIDS patients without PCP (group B; mean, 1.01 mumol; range, 0.20-2.00; s.d., 0.67; s.e., 0.25; 95% CI, 0.39-1.64) or asymptomatic HIV-positive patients (group C; mean, 1.28 mumol; range, 0.49-1.80; s.d., 0.51; s.e., 0.19; 95% CI, 0.81-1.76) (P < 0.05). There was no significant difference between groups B and C. All patients recorded PD20-FEV1 within the asthmatic range of bronchial hyper-responsiveness. CONCLUSIONS: These results suggest that development of PCP in a small group of HIV-infected patients induces a significantly greater degree of bronchial hyper-responsiveness.

Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS Adult AIDS-Related Opportunistic Infections/*COMPLICATIONS/DRUG THERAPY/ *PHYSIOPATHOLOGY Bronchoconstriction/DRUG EFFECTS/*PHYSIOLOGY Forced Expiratory Volume Histamine/PHARMACOLOGY Human Male Pentamidine/ADVERSE EFFECTS Pneumonia, Pneumocystis carinii/*COMPLICATIONS/DRUG THERAPY/ *PHYSIOPATHOLOGY JOURNAL ARTICLE
930430
M9340799

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