The lungs are commonly affected in patients infected with HIV, with over 60% of patients having at least one respiratory episode during the course of their disease.
When immune responses are relatively well preserved in early HIV infection the pattern of respiratory infections is similar to that found in the general population, although they occur with greater frequency.
The risk of opportunistic infections and tumours increases as progressive HIV-induced immunosuppression occurs. Over recent years there have been several changes in the pattern of lung disease seen in those infected with HIV. These changes may be accounted for by the widespread availability and uptake of prophylaxis for Pneumocystis carinii pneumonia and combination antiretroviral therapy (also known as highly active antiretroviral therapy or HAART).Box 6.1 HIV-associated respiratory disease
Infections
Bacterial bronchitis/sinusitis
Bacterial pneumonia
Tuberculosis
P. carinii pneumonia Fungal pneumonia Cytomegalovirus pneumonitis
Malignancy
Kaposi's sarcoma Lymphoma Lung cancer
Non-malignant conditions
Lymphoid interstitial pneumonitis
Non-specific pneumonitis
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