Clinical significance of resolution of chest X-ray findings in HIV-infected children with lymphocytic interstitial pneumonitis (LIP).
Lymphocytic interstitial pneumonitis (LIP) in HIV-infected children is generally associated with better prognosis as compared with children with Pneumocystis carinii pneumonia (PCP). We prospectively studied 12 cases of HIV-infected children with LIP over a 4-year period in an effort to document one aspect of the natural history of this clinical entity. Severe CD4 lymphocytopenia was associated with complete resolution of the chest X-ray findings in five patients, one of whom died of disseminated Mycobacterium avium complex. A second patient developed rapid-onset subacute HIV encephalopathy at the time when the CD4-lymphocyte count declined from 589 to 39, and the lung findings resolved spontaneously. The resolution of the lung pathology may be the first indication of severe immune suppression and a warning of the increased risk for opportunistic infections. Therefore, in those settings where diagnostic laboratory facilities are not easily available, the resolution of the reticulonodular changes on chest radiographs is a poor prognostic sign in HIV-infected children with LIP.
Prosper
M
M
Department of Pediatrics, Woodhull Medical and Mental Health Center, 760 Broadway, Brooklyn, NY 11206, USA.
Omene
J A
JA
Ledlie
Odita
J C
JC
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000276:immunology; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000276:immunology; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D011859:Radiography; D012307:Risk Factors