Changing global epidemiology of pulmonary manifestations of HIV/AIDS.
Tremendous advances have occurred in the care of patients with HIV/AIDS resulting from the advent of highly active antiretroviral therapy (HAART). This has led to differences in the presentations of HIV-related pulmonary disease. Infections such as bacterial pneumonias, particularly Streptococcus pneumoniae, remain commonplace, while opportunistic agents such as Pneumocystis jirovecii remain a concern in patients without adequate access to optimal medical care. The tuberculosis epidemic, once thought to be slowing, has been re-energized by the spread of HIV, particularly in sub-Saharan Africa. Unusual inflammatory responses due to a phenomenon of immune reconstitution, are now recognized as a consequence of HAART, with a reported incidence of IRIS in this setting ranges from 7 to 45% in retrospective reviews. Noninfectious pulmonary conditions such as chronic obstructive lung disease and pulmonary malignancies are gaining prominence as patients are accessing antiretroviral care and enjoying significantly extended survival.
Hull
Mark W
MW
Canadian HIV Trials Network, University of British Columbia, Vancouver, BC, Canada.
Phillips
Peter
P
Division of Infectious Diseases, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Montaner
Julio S G
JSG
Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. Electronic address: 8527jmontaner@cfenet.ubc.ca.
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data*; D002648:Child; D019049:Developed Countries; D003906:Developing Countries; D014943:Global Health; D006801:Humans; D008171:Lung Diseases / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D012959:Socioeconomic Factors