Pneumonia in patients with HIV infection

The epidemiologic shift in HIV-infected populations from homosexual men to intravenous drug users and their sexual partners, together with the wide application of antipneumocystis prophylaxis and a better understanding of the broad range of HIV-associated illnesses, has changed our concept of the spectrum of lung infections that occur in patients with HIV infection. Bacterial pneumonia, not PCP, is the most common lower respiratory infection. Newer therapies of mild-to-moderate PCP increase the treatment options. The worldwide increase in tuberculosis cases is attributable to coinfection with HIV, and multidrug-resistant tuberculosis is now a serious threat, especially in the inner cities. Fungal pneumonias occur with increased frequency in patients with HIV infection, depending on the geographic factors and the severity of immunodeficiency.