HIV and the lung

The spectrum of HIV-related respiratory diseases has evolved since initial years of the epidemic. With changes in the definition of AIDS, shifts in demographic and behavior risk factors for HIV infection, and Pneumocystis carinii pneumonia (PCP) prophylaxis, the incidence of bacterial pneumonia has matched that of PCP. Combination antiretroviral therapy with protease inhibitors has been a major contributor to a recent decline in HIV-related opportunistic infections. These advances will almost certainly affect the rates of PCP, bacterial pneumonia, and other pulmonary opportunistic infections associated with HIV disease. Over the last year, progress has been made in assessment of risk factors, diagnosis, treatment, and prognosis of several HIV-related pulmonary infections including PCP, cytomegalovirus pneumonia, mycobacterial infections, and fungal pneumonias. More information has become available regarding HIV-related airway disease, and rarer complications including primary pulmonary hypertension and primary lung cancer.