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

Mulugeta Woji*, Dr. Zeleke W/Tinsae and Dr. Adane Bitew

Background: Many fungi cause pulmonary disease in HIV-infected patients. Pulmonary infections due to mycosis remain a major cause of both morbidity and mortality among HIV patients. HIV infection reduces the number and functionality of CD4 helper lymphocytes that direct and coordinate acquired immunity against most pathogens. The decrease in CD4+ T lymphocyte count leads to various opportunistic infections (OI) in HIV infected persons. Identification of the fungal species is important, as it helps in the initiation of specific antifungal therapy which improves the outcome of treatment. Systemic fungal infections are more frequent and sever in patients with HIV infection. Objective: The aim of this study was to determine the prevalence of pulmonary fungal pathogens and their association with CD4+ lymphocyte count among HIVinfected patients. Method: A prospective cross sectional study was conduct at ALERT hospital from September, 2021 to April, 2022. Consented participants’ information was collected using structured questionnaire. A total of 385 sputum and blood samples from HIV infected patients were collected aseptically by convenient sampling method and the sputum samples were inoculated into the sputum samples into SDA (Sabrouad’s Dextrose Agar). Fungal culture identification was performed by studying the macroscopic and microscopic characteristics of their colonies on SDA medium. Also Germ tube production test, CHROM agar test, Indian ink test and Lacto phenol cotton blue stain were used for further identification of fungal isolates and CD4+ T lymphocyte count were determined using BD FACSPristo machine. The data were entered and analyzed using SPSS software version 20. Descriptive statistics and logistic regressions were used and P-value < 0.05 was considered as significant. Result: The prevalence of pulmonary fungal pathogens among HIV infected patient was 69.6% and nine different pulmonary fungal species were isolated from 268 cultures positive isolates. Candida Albicans and Aspergillus niger are among the predominant pulmonary fungal species and Cryptococcus species and Mucor specie showed the least. The highest pulmonary fungal isolates growth rate were observed from patients that have CD4+ T lymphocyte counts <200 cells/ml. Conclusion: The findings in this study reveal a high prevalence of pulmonary mycosis. It is higher among HIV infected patients with their immune status indicated by CD4+ cell counts <350 cell/ml. Pulmonary fungal infections in AIDS patients are a common and unrecognized problem. Early diagnosis is essential for effective management of the patients.