Induced sputum in HIV- infected patients: diagnosis of acute pulmonary diseases.

OBJECTIVE To make a narrative review of the accuracy of induced sputum for diagnosis of pulmonary disease in HIV-infected patients. DATA SOURCES The MEDLINE, LILACS, EMBASE and the Cochrane Library were searched. reference lists, abstracts of conference proceedings and scientific meetings were hand searched. METHODS STUDY SELECTION Fifteen articles that specifically addressed the stated purpose were selected. DATA EXTRACTION Yield of sputum induction and fiberoptic bronchoscopy with bronchoalveolar lavage were analyzed using explicit methodologic to evaluate the quality of clinical trials. RESULTS Sputum induction demonstrated 55.5% sensitivity and 98.6% specificity to Pneumocystis pneumonia. Sensitivity of sputum induction was significantly higher with immunofluorescence than with cytochemical staining (67.1 versus 43.1%). Sputum induction for diagnosis of bacterial pneumonia demonstrated 60% sensitivity, 40% specificity, 80% positive predictive value, 20% negative predictive value and 56% accuracy. In relation to tuberculosis, sputum induction demonstrated 36% sensitivity, 100% specificity, 100% positive predictive value and 54.2% negative predictive value. CONCLUSION Sputum induction seems to be effective and safe for diagnosis of pulmonary diseases in HIV-infected patients.