[HIV Infection/AIDS and respiratory tract infections in Japan]

Recent advances in the chemotherapeutic agents against HIV enabled us to conduct combination therapies using two nucleoside reverse transcriptase inhibitors and a protease inhibitor. The three-drug combination chemotherapies have been shown to be very potent in inhibiting HIV replication; they markedly suppress plasma HIV-RNA levels, elevate CD4 counts, reduce opportunistic infections and prolong survival of the patients. Early and hard treatment is now recommended. Among opportunistic infections in patients with HIV infection/AIDS, most frequent are respiratory tract infections including Pneumocystis carinii pneumonia, bacterial pneumonia, pulmonary tuberculosis, CMV pneumonia and fungus infections. Sensitivity and specificity of PCR method to detect Pneumocystis carinii are much better than the conventional Grocott stain of sputa. Early diagnosis of tuberculosis and atypical mycobacteriosis became possible using PCR and other molecular technology. Multi-drug resistant tuberculosis is fortunately rare among Japanese HIV-positive patients. Early and correct diagnosis of opportunistic infections markedly improves the prognosis of the patients.