title: Severe airflow obstruction in vertically acquired HIV infection.
abstract: It is becoming increasingly clear that human immunodeficiency virus (HIV) infection, either independently or in concert with opportunistic infections like pulmonary tuberculosis, is a risk factor for the development of chronic airflow limitation. In the majority of patients the etiology of this obstructive ventilatory defect is multifactorial. Post-infectious obliterative bronchiolitis, post-tuberculous lung damage (including bronchiectasis), immune reconstitution and the direct effects of HIV viral infection may all play a role. With increases in life expectancy and decreases in infectious complications in patients taking antiretroviral medications, the importance of HIV-associated chronic lung disease as a cause of pulmonary disability is likely to increase. This is particularly relevant in regions like sub-Saharan Africa, where both HIV infection and tuberculosis are highly prevalent. Here, to illustrate the complexity of this interaction, we present the case of a 15-year-old girl with vertically acquired HIV infection, multiple episodes of pulmonary infection, and severe airflow obstruction.
authors.affiliation: Division of Pulmonology, Department of Medicine, Groote Schuur Hospital and UCT Lung Institute, University of Cape Town Cape Town, South Africa.
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Calligaro
authors.affiliation: Division of Pulmonology, Department of Medicine, Groote Schuur Hospital and UCT Lung Institute, University of Cape Town Cape Town, South Africa.
authors.forename: Aliasgar
authors.initials: A
authors.lastname: Esmail
authors.affiliation: Division of Pulmonology, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital Cape Town, South Africa.
authors.forename: Diane M
authors.initials: DM
authors.lastname: Gray
keywords: Airflow obstruction; HIV infection; bronchiectasis; obstructive lung disease; pulmonary complications of HIV