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Chest. 2008 Dec;134(6):1287-1298. doi: 10.1378/chest.08-0364.

Changing global epidemiology of pulmonary manifestations of HIV/AIDS.

Author information

Canadian HIV Trials Network, University of British Columbia, Vancouver, BC, Canada.
Division of Infectious Diseases, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. Electronic address:


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.

[Indexed for MEDLINE]

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