Prospective evaluation of fever of unknown origin in patients infected with the human immunodeficiency virus. Grupo Andaluz para el Estudio de las Enfermedades Infecciosas

The aim of this study was to determine the frequency and aetiology of fever of unknown origin (FUO) in patients infected with the human immunodeficiency virus (HIV), to assess the value of the tests used in its diagnosis, and to evaluate possible models of diagnosis for the causes found most frequen...

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Bibliographic Details
Published in:European journal of clinical microbiology & infectious diseases 1996-09, Vol.15 (9), p.705-711
Main Authors: Lozano, F, Torre-Cisneros, J, Bascuñana, A, Polo, J, Viciana, P, García-Ordóñez, M A, Hernández-Quero, J, Márquez, M, Vergara, A, Díez, F, Pujol, E, Torres-Tortosa, M, Pasquau, J, Hernández-Burruezo, J J, Suárez, I
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
AIDS/HIV
Female
Fever of Unknown Origin - epidemiology
Fever of Unknown Origin - etiology
HIV Infections - complications
Humans
Incidence
Logistic Models
Male
Middle Aged
Multivariate Analysis
Prospective Studies
Risk Factors
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Summary:The aim of this study was to determine the frequency and aetiology of fever of unknown origin (FUO) in patients infected with the human immunodeficiency virus (HIV), to assess the value of the tests used in its diagnosis, and to evaluate possible models of diagnosis for the causes found most frequently. One hundred twenty-eight (3.5%) of 3603 hospitalised HIV-positive patients evaluated from October 1992 to December 1993 had FUO, defined by established criteria. Eighty-six percent of patients with FUO had previously progressed to AIDS. The median CD4+ cell count was 46/mm3. A definite diagnosis was made in 96 (75%) of the 128 patients and a possible diagnosis in 24 (18.7%). whilst no diagnosis was made in eight cases (6.2%). Tuberculosis (48.3%), visceral leishmaniasis (16%), and infection by Mycobacterium avium complex (6.9%) were the diseases found most frequently. The most useful diagnostic tests were liver biopsy (68.9%) and bone marrow aspirate/biopsy (39.7%). It is not possible to predict clinically the cases of FUO due to tuberculosis, whilst thrombocytopaenia < 100,000 cells/mm3 alone is useful for differentiating the cases of visceral leishmaniasis, with a negative predictive value of 95.2%.
ISSN:0934-9723