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Pneumonia associated with HIV infection [Article de Revue]

 
[Pneumonie associée à une infection au VIH]
Feldman, Charles
Current opinion in infectious diseases. 2005/04; 18(2) : 165-170
Summary: La pneumonie survient fréquemment chez les patients infectés par le VIH et cette revue porte sur les données récentes en épidémiologie, pathogénèse, caractérstiques cliniques, traitement et prévention de cette affection. Les études récentes montrent que l'antibioprophylaxie, l'introduction d'une thérapie antirétrovirale active, la reconnaissance de facteurs de risque spécifiques, de nouvelles stratégies de traitement antibiotique et des vaccins efficaces pourraient aider à diminuer l'impact de la pneumonie chez les patients infectés par le VIH.

PURPOSE OF REVIEW: Pneumonia occurs commonly in HIV-infected patients and this review highlights some of the recent findings in the epidemiology, pathogenesis, clinical features, treatment and prevention of this condition.
RECENT FINDINGS: Pneumonia remains an important cause of morbidity and mortality in HIV-infected patients. A number of factors have been identified that increase the risk of pneumonia. Cigarette smoking increases the risk of lung colonization, as well acute pneumonia due to Pneumocystis jiroveci, and has been documented to produce significant depression of the phagocytic function of alveolar macrophages in HIV-infected patients, which may underlie this risk. Legionella pneumophila infections appear to be uncommon in HIV-infected patients, while pneumonia with Streptococcus pneumoniae continues to occur with regularity, including infections with antibiotic-resistant isolates. Pneumocystis pneumonia occurs with a low incidence in patients receiving HAART, once the CD4 count increases to over 200 microl. Studies of invasive pneumococcal infections (predominantly pneumonia) indicate that in critically ill cases, including HIV-seropositive patients, combination antibiotic therapy is associated with a lower mortality than monotherapy. The 23-polyvalent pneumococcal vaccine has been shown to reduce the risk of pneumococcal infection in HIV-infected adults receiving HAART, and a 9-valent conjugate pneumococcal vaccine has been shown to reduce the incidence of radiologically confirmed pneumonia in HIV-seropositive and HIV-seronegative children.
SUMMARY: Pneumonia remains an important condition in HIV-infected patients, but recent studies demonstrate that antibiotic prophylaxis, the introduction of HAART, recognition of specific risk factors, new antibiotic treatment strategies and effective vaccines should serve to decrease its impact.
(RESUME D'AUTEUR)
Publication
2005/04

Pages
165-170

Language
Anglais

Number of ref
51

ID notice
319294

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