Pulmonary Manifestations of HIV

Aka: Pulmonary Manifestations of HIV, HIV Related Pulmonary Complications, AIDS Associated Lung Conditions

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II. Epidemiology

  1. HIV and Tobacco Abuse both play major roles in the increased risk of COPD and Lung Cancer in HIV patients
    1. Collini (2016) Curr Opin Infect Dis 29(1):31-8 +PMID:26555039 [PubMed]

III. Causes: General causes lung findings in HIV

  1. Typical Bacterial Pneumonias are the most common Bacterial Pneumonias seen in HIV and AIDS patients
    1. Pneumococcal Pneumonia
    2. HaemophilusInfluenzae
  2. Mycobacterium
    1. Tuberculosis
      1. May occur at any CD4, but especially occurs in advanced HIV with CD4 < 500
    2. Mycobacterium Avium Complex or MAC (AIDS)
  3. Parasitic
    1. Toxoplasmosis
  4. Viruses (CD4 <50)
    1. Cytomegalovirus (CMV)
    2. Herpes Simplex Virus (HSV)
  5. Fungal (advanced HIV and AIDS)
    1. CD4<200
      1. Pneumocystis (PCP Pneumonia)
    2. CD4<50
      1. Cryptococcis
      2. Histoplasmosis
      3. Aspergillosis
      4. Candidiasis
  6. Malignancy
    1. Kaposi's Sarcoma
    2. Non-Hodgkin's Lymphoma

IV. Causes: Cavitary Lesions

  1. Tuberculosis
  2. Aspergillus
  3. Pneumocystis carinii
  4. Pneumococcus
  5. Cryptococcus neoformans
  6. Rhodococcus equi
  7. Gram Negative Bacilli (especially Pseudomonas)

V. Causes: Nodular lesions

  1. Cryptococcus
  2. Histoplasmosis
  3. Tuberculosis
  4. Pneumocystis carinii
  5. Bacterial Pneumonia
  6. Malignancies
    1. Kaposi's Sarcoma
    2. Non-Hodgkin's Lymphoma

VI. Causes: Hilar Adenopathy

  1. Tuberculosis
  2. Kaposi's Sarcoma
  3. Non-Hodgkin's Lymphoma
  4. Pneumocystis carinii (Uncommon)

VII. Causes: Pleural Effusion

  1. Tuberculosis
  2. Fungal Pneumonia
  3. Kaposi's Sarcoma
  4. Non-Hodgkin's Lymphoma

VIII. Prevention

  1. Tobacco Cessation
  2. Pneumococcal Vaccine
  3. Influenza Vaccine

IX. References

  1. Swadron (2019) Pulmonology 2, CCME Board Review, accessed 6/18/2019
  2. Chu (2017) Am Fam Physician 96(3): 161-9 [PubMed]

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