PREVALENCE AND PROFILE OF PULMONARY FUNGAL PATHOGENS AMONG HIV-INFECTED PATIENTS ATTENDING ALERT HOSPITAL, ADDIS ABABA ETHIOPIA

Background: Many fungi cause pulmonary disease in HIV-infected patients.Pulmonary infections due to mycosis remain a major cause of both morbidity andmortality among HIV patients. HIV infection reduces the number andfunctionality of CD4 helper lymphocytes that direct and coordinate acquiredimmunity against most pathogens. The decrease in CD4+ T lymphocyte countleads to various opportunistic infections (OI) in HIV infected persons.Identification of the fungal species is important, as it helps in the initiation ofspecific antifungal therapy which improves the outcome of treatment. Systemicfungal infections are more frequent and sever in patients with HIV infection.Objective: The aim of this study was to determine the prevalence of pulmonaryfungal pathogens and their association with CD4+ lymphocyte count among HIVinfectedpatients. Method: A prospective cross sectional study was conduct atALERT hospital from September, 2021 to April, 2022. Consented participants’information was collected using structured questionnaire. A total of 385 sputumand blood samples from HIV infected patients were collected aseptically byconvenient sampling method and the sputum samples were inoculated into thesputum samples into SDA (Sabrouad’s Dextrose Agar). Fungal cultureidentification was performed by studying the macroscopic and microscopiccharacteristics of their colonies on SDA medium. Also Germ tube production test,CHROM agar test, Indian ink test and Lacto phenol cotton blue stain were usedfor further identification of fungal isolates and CD4+ T lymphocyte count weredetermined using BD FACSPristo machine. The data were entered and analyzedusing SPSS software version 20. Descriptive statistics and logistic regressionswere used and P-value < 0.05 was considered as significant. Result: Theprevalence of pulmonary fungal pathogens among HIV infected patient was 69.6%and nine different pulmonary fungal species were isolated from 268 culturespositive isolates. Candida Albicans and Aspergillus niger are among thepredominant pulmonary fungal species and Cryptococcus species and Mucorspecie showed the least. The highest pulmonary fungal isolates growth rate wereobserved from patients that have CD4+ T lymphocyte counts <200 cells/ml.Conclusion: The findings in this study reveal a high prevalence of pulmonarymycosis. It is higher among HIV infected patients with their immune statusindicated by CD4+ cell counts <350 cell/ml. Pulmonary fungal infections in AIDSpatients are a common and unrecognized problem. Early diagnosis is essential foreffective management of the patients.