Pleural effusion and human immunodefeciency virus infection in adult Zambians : a clinical and laboratory study

Abstract

A Clinical and laboratory study was carried out on 80 adult Zambian patients with pleural effusion in order to determine common features and to establish any association with human immunodeficiency virus (HIV) infection at the University Teaching Hospital, Lusaka. No such a study had been done before in Zambia (before or after the advent of the HIV epidemic). Of those patients with pleural effusion tested for retroviral infection 53/64 (82.81%) were found to be HIV-seropositive, aged between 15 and 50 years and about equally distributed between both sexes. They all had a poor socioeconomic background coming from crowded highdensity residential areas. No history of tuberculosis contact was available in 61/80 (76.25%) patients suggesting endogenous reactivation of dormant infection in these cases. Lympadenopathy, nail changes, hair changes, dermatoses, atypical Kaposis Sarcoma, Herpes Zoster and Oral Candidiasis had a high predictive value (over 80%) for HIV infection, and 29/80 (36.25%) actually fulfilled the WHO clinical criteria for the diagnosis of AIDS/ARC in developing countries.