[Infectious respiratory complications of AIDS]

Respiratory infections are particularly frequent in HIV infection. They depend upon the degree of immunodeficiency, the geographical region and a possible prophylaxis. Bronchopneumopathies caused by pyogenic organisms (notably pneumococci) appear when the number of T4 lymphocytes is little reduced. Pulmonary tuberculosis, particularly frequent in Africans and Haitians, occurs in patients with moderate immunodeficiency (T4 between 200 and 300/mm3). HIV infections modify the epidemiology of tuberculosis in Africa, but also in the USA and probably in Europe. Despite a well-established prophylaxis, pneumocystosis, which develops when the number of T4 cells falls below 200/mm3, is the opportunistic pathology which in most cases points to AIDS in the USA and in France. Atypical mycobacterial infections (Mycobacterium avium complex) and CMV infections occur at a late stage of the disease in patients with severe immunodeficiency. Noticeable advances have recently been made in the treatment of these complications.