Lymphocytic bronchiolitis associated with HIV infection

Patients with the acquired immune deficiency syndrome (AIDS) frequently develop interstitial lung disease. This is due most commonly to opportunistic infections, but malignancy and lymphocytic interstitial pneumonitis have also been associated with the syndrome. In contrast, there has been little reported about airways disease in patients with HIV infection. We describe a patient with AIDS-related complex who presented with symptoms and radiographic evidence of micronodular interstitial lung disease. Transbronchial biopsy revealed a lymphocytic bronchiolitis but no evidence of interstitial lung disease and a marked T-suppressor lymphocytosis was found on analysis of the bronchoalveolar lavage (BAL) specimen. Routine fungal, viral and bacterial cultures did not yield an etiologic agent. This case raises the possibility that lymphocytic bronchiolitis may represent another pulmonary manifestation of HIV infection.