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Global Medicine |

Changing Global Epidemiology of Pulmonary Manifestations of HIV/AIDS

Mark W. Hull, MD, MHSc, FRCPC; Peter Phillips, MD, FRCPC; Julio S. G. Montaner, MD, FRCPC, FCCP
Author and Funding Information

*From the Canadian HIV Trials Network (Dr. Hull); Division of AIDS (Dr. Montaner), Faculty of Medicine, University of British Columbia; and Division of Infectious Diseases (Dr. Phillips), Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.

Correspondence to: Julio S. G. Montaner, MD, FCCP, Director, BC Centre for Excellence in HIV/AIDS 667, 1081 Burrard St, Vancouver BC, V6Z 1Y6, Canada; e-mail: 8527jmontaner@cfenet.ubc.ca


Dr. Hull has received honoraria for speaking engagements and/or consultancy meetings from the following: Merck Frosst and Pfizer. He has been a coinvestigator on grants supported in part by Wyeth Pharmaceuticals. Dr. Phillips has no conflict of interest to disclose. Dr. Julio Montaner has received grants from, served as an ad hoc advisor to, or spoke at various events sponsored by Abbott, Argos Therapeutics, Bioject Inc, Boehringer Ingelheim, BMS, Gilead Sciences, GlaxoSmithKline, Hoffmann-La Roche, Janssen-Ortho, Merck Frosst, Panacos, Pfizer, Schering, Serono Inc, TheraTechnologies, Tibotec (J&J), and Trimeris.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


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

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