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Related Subjects: |AIDS (HIV) Neurological Disease |AIDS (HIV) Respiratory disease |AIDS Dementia Complex (HIV) |AIDS HIV Infection |AIDS(HIV) Gastrointestinal Disease |Acute Retroviral Syndrome (HIV) |HIV and Post-Exposure Prophylaxis (PEP) |HIV and Pre-exposure prophylaxis |HIV associated nephropathy (HIVAN) |HIV disease Assessment

AIDS (HIV) Respiratory Diseases

Respiratory diseases are common in individuals with AIDS (Acquired Immunodeficiency Syndrome) due to their weakened immune systems. These diseases can be caused by a variety of opportunistic pathogens, including bacteria, viruses, fungi, and parasites. Below is an overview of some common respiratory diseases associated with AIDS.

Bacterial Infections

• Pneumonia:
  • Often caused by Streptococcus pneumoniae and Haemophilus influenzae.
  • Symptoms: Cough, fever, chest pain, and difficulty breathing.
  • Treatment: Antibiotics and supportive care.
• Mycobacterium tuberculosis (TB):
  • HIV-infected individuals are at higher risk for active TB.
  • Symptoms: Chronic cough, weight loss, night sweats, and fever.
  • CXR: atypical features e.g. infectivity without cavitation. Mid zonal rather than apical findings.
  • Treatment: Combination of anti-tuberculous drugs for an extended period.
• Mycobacterium avium complex (MAC):
  • Occurs in advanced HIV infection (CD4 count < 50 cells/µL).
  • Symptoms: Fever, weight loss, night sweats, and respiratory symptoms.
  • Treatment: Combination antibiotic therapy.

Viral Infections

• Cytomegalovirus (CMV):
  • Can cause pneumonia in HIV-infected individuals.
  • Symptoms: Fever, cough, and shortness of breath.
  • Treatment: Antiviral medications such as ganciclovir or valganciclovir.
• Herpes Simplex Virus (HSV):
  • May cause severe respiratory disease in immunocompromised patients.
  • Symptoms: Fever, cough, and respiratory distress.
  • Treatment: Antiviral therapy with acyclovir or valacyclovir.

Fungal Infections

• Pneumocystis jirovecii pneumonia (PCP):
  • One of the most common opportunistic infections in AIDS patients.
  • Mild to moderate dyspnoea, exercise hypoxia. Pulmonary infiltrates on CXR. Low CD4 count < 200.
  • Symptoms: Fever, non-productive cough, and shortness of breath.
  • Complications: Pneumothorax
  • Treatment: Trimethoprim-sulfamethoxazole (TMP-SMX) or alternative regimens if allergic.
• Cryptococcosis:
  • Caused by Cryptococcus neoformans, can lead to severe pneumonia.
  • Symptoms: Cough, fever, and chest pain.
  • Treatment: Antifungal medications such as fluconazole or amphotericin B.
• Histoplasmosis:
  • Caused by Histoplasma capsulatum, can disseminate in immunocompromised individuals.
  • Symptoms: Fever, cough, and shortness of breath.
  • Treatment: Antifungal therapy with itraconazole or amphotericin B.

Parasitic Infections

• Toxoplasmosis:
  • Caused by Toxoplasma gondii, can lead to severe respiratory symptoms.
  • Symptoms: Fever, cough, and shortness of breath.
  • Treatment: Combination therapy with pyrimethamine and sulfadiazine.

Prevention and Management

• Prophylactic medications (e.g., TMP-SMX for PCP) for high-risk patients.
• Regular monitoring of CD4 counts and viral load.
• Early initiation of antiretroviral therapy (ART) to maintain immune function.
• Vaccinations (e.g., pneumococcal, influenza) to prevent infections.
• Prompt treatment of respiratory symptoms and infections.