Abstract

CORZO, Roque Julio; ROJAS, Elsa Marina; FIGUEROA, Claudia Lucía  and  DAZA, Nelson. Prevalence of opportunistic infections in HIV-AIDS patients based on microscopic examination of bone marrow. Acta Med Colomb [online]. 2015, vol.40, n.2, pp.93-100. ISSN 0120-2448.

Introduction: the diagnostic utility of the study of bone marrow in patients with HIV has been evaluated in a few studies in Latin America. The frequency with which this study contributes to the identification of opportunists in our country is unknown. Design: Analytical cross-sectional study. Methods: a retrospective review of medical records of HIV-AIDS patients hospitalized at the University Hospital of Santander between 2009 and 2012 who underwent bone marrow study to evaluate cytopenia. Cases with a history of malignancy and chemotherapy three months before vacuuming were excluded. Sample size for evaluation of partnerships was calculated. Results: 92 samples of bone marrow of 83 patients were evaluated, finding a prevalence of opportunistic infection in 23% with direct examination and 34.5% when cultures were performed. Histoplasmosis was the most common infection with 20.6%, followed by 10.8% Mycobacteria and Cryptococcus spp infection 3.2%. The hematologic clinic that prevailed in the positive cases for opportunist was pancitopenia febril (in 41% of the cases) and monocitopenia (in 32% of the cases). The LDH ≥ 600 IU / dL was associated with a positive diagnosis for opportunistic infection in the microscopic study of bone marrow, with OR 5.42 (95% CI 1.09-26.9 p = 0.03). Conclusion: the study of bone marrow in patients with HIV-AIDS allowed a diagnosis of opportunistic infection in a quarter of cases, and is especially useful for early identification of histoplasmosis. Studies to assess the impact on hospital stay, clinical outcomes and costs of using this test early in the approach to HIV patients hospitalized in Internal Medicine are required. (Acta Med Colomb 2015; 40: 93-100).

Keywords : acquired immunodeficiency syndrome; microscopic examination of bone marrow; opportunistic infection; diagnostic utility.

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