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Approach to the HIV-infected patient with pulmonary symptoms

Diane E Stover, MD
Section Editors
John G Bartlett, MD
Talmadge E King, Jr, MD
Deputy Editor
Howard Libman, MD, FACP


The acquired immunodeficiency syndrome (AIDS) epidemic remains one of the most important global health problems of the 21st century [1-4].

However, the incidence of AIDS-related opportunistic infections (OIs) declined dramatically in the United States and Europe following the introduction of potent antiretroviral therapy (ART). Despite these gains, pulmonary disease remains a significant cause of morbidity and mortality [5-7].

Just as the pulmonary disorders associated with HIV infection have changed in the 21st century, the approach to the diagnosis of pulmonary disease has evolved as well (figure 1). The clinical assessment of pulmonary symptoms in HIV-infected patients will be reviewed here; specific conditions and their management are discussed separately. (See appropriate topic reviews).


The spectrum of pulmonary disease in patients with HIV has changed over the past decades [5-8]. Although Pneumocystis pneumonia (PCP) remains the most common AIDS-defining opportunistic infection in the United States, its incidence has decreased with improved prophylactic and antiretroviral therapy. (See "Clinical presentation and diagnosis of Pneumocystis pulmonary infection in HIV-infected patients".)

HIV-infected patients are at risk for a number of other pulmonary infections in addition to PCP [9]. Bacterial pneumonia remains a common complication in HIV-infected patients, and has increased as a proportion of diagnosed pulmonary infections despite an overall decrease in the number of cases [10,11]. A detailed discussion of bacterial pulmonary infections in HIV-infected patients is presented elsewhere. (See "Bacterial pulmonary infections in HIV-infected patients".)

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Literature review current through: Nov 2017. | This topic last updated: Feb 06, 2017.
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