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Pneumonia in the patient with HIV infection
1Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Abstract:
The lower respiratory tract has always been a major site of complications in patients with human immunodeficiency virus (HIV) infection. In the era before Pneumocystis carinii prophylaxis (PCP) this organism accounted for more than 70% of initial AIDS-defining diagnoses and was by far the most common identifiable cause of mortality. Even in the era of prophylaxis, PCP continues to be the most common AIDS-defining diagnosis and the most common identifiable cause of death. Despite the historic emphasis on PCP, bacterial pneumonia seems to be at least as common or more common. A substantial spectrum of other opportunistic pathogens are also commonly encountered in these patients. This article reviews pneumonia in patients with HIV infection.
Insights
Pneumonia is a common complication in patients with human immunodeficiency virus (HIV). While Pneumocystis pneumonia (PCP) was historically dominant, bacterial pneumonia and other opportunistic infections are now equally or more prevalent in HIV patients.
Area of Science:
- Infectious Diseases
- Pulmonology
- Immunology
Background:
- The lower respiratory tract is a frequent site of complications in patients with human immunodeficiency virus (HIV).
- Before Pneumocystis pneumonia (PCP) prophylaxis, PCP was the most common cause of AIDS-defining diagnoses and mortality (>70%).
- Even with prophylaxis, PCP remains a leading AIDS-defining diagnosis and cause of death in HIV patients.
Purpose of the Study:
- To review the spectrum of pneumonia in patients with HIV infection.
- To highlight the changing landscape of respiratory infections in HIV-positive individuals.
Main Methods:
- Literature review of pneumonia in HIV patients.
- Analysis of historical and current trends in causative pathogens.
Main Results:
- Pneumocystis pneumonia (PCP) historically dominated, causing over 70% of initial AIDS diagnoses and deaths before prophylaxis.
- Even with prophylaxis, PCP remains the most common AIDS-defining diagnosis and cause of death.
- Bacterial pneumonia is now as common as, or more common than, PCP.
- A wide range of other opportunistic pathogens also frequently cause pneumonia in HIV patients.
Conclusions:
- Pneumonia remains a significant complication in HIV infection.
- While PCP is historically emphasized, bacterial pneumonia and other opportunistic infections are major contributors to morbidity and mortality.
- Comprehensive understanding and management of diverse pneumonias are crucial for HIV patient care.