HIV-Associated Bacterial Pneumonia

Feldman, Charles; Anderson, Ronald

doi:10.1016/j.ccm.2013.01.006

Cited by 48 publications

(39 citation statements)

References 83 publications

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“…Pulmonary infections Community-acquired pneumonia It is well recognised that smoking is an independent and eminently preventable risk factor for the development of CAP in both HIV-infected and -uninfected individuals [13,[93][94][95][96][97][98][99]. In HIV-infected patients, the increased risk for CAP, which is evident at all levels of immunosuppression, is estimated to be between two-and five-fold, increasing as the CD4 cell count declines [13,100].…”

Section: Clinical Consequences Of the Cumulative Effects Of Hiv Infecmentioning

confidence: 99%

“…pneumoniae is the most common cause of CAP in both HIV-infected and -uninfected patients, accounting for ∼20% of cases of all-cause bacterial pneumonia, 40% of cases of CAP in which a specific pathogen is identified and 70% of cases of bacteraemic pneumonia [13,97,100]. The rates of invasive pneumococcal disease (IPD) associated with HIV infection are estimated to be up to 100-fold higher compared to HIV-uninfected persons [97]. Predictably, smoking, as well as alcohol abuse, are also significant risk factors for IPD, with both these harmful lifestyle aspects over-represented in those infected with HIV [100,101].…”

Section: Clinical Consequences Of the Cumulative Effects Of Hiv Infecmentioning

confidence: 99%

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Impact of HIV infection and smoking on lung immunity and related disorders

2015

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HIV-infected persons not only have higher rates of smoking than the general population, but are also unusually vulnerable to the associated adverse health effects, both infective and noninfective in origin. Indeed, in the setting of well-organised care and availability of highly active antiretroviral therapy, HIV-infected smokers lose more life-years to smoking than to HIV infection per se, presenting a major challenge to healthcare providers. Not surprisingly, the respiratory system is particularly susceptible to the damaging interactive chronic inflammatory and immunosuppressive effects of HIV and smoking, intensifying the risk of the development of opportunistic infections, as well as lung cancer and obstructive lung disorders. The impact of smoking on the immunopathogenesis and frequencies of these respiratory conditions in the setting of HIV infection, as well as on the efficacy of antiretroviral therapy, represent the primary focus of this review. @ERSpublications Smoking exacerbates the immunosuppressive/pro-inflammatory effects of HIV, increasing the risk of pulmonary disease

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Section: Clinical Consequences Of the Cumulative Effects Of Hiv Infecmentioning

confidence: 99%

Section: Clinical Consequences Of the Cumulative Effects Of Hiv Infecmentioning

confidence: 99%

Impact of HIV infection and smoking on lung immunity and related disorders

2015

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“…However, the concept of opportunism was flawed from the start because nonopportunistic microbes also caused disease in patients with impaired immunity, and opportunistic microbes were rarely isolated in apparently normal patients, making it impossible to separate "opportunistic" and "nonopportunistic" microbes on the basis of the host in which they caused disease. For example, patients with AIDS were more susceptible to pneumococcal pneumonia (11), in addition to AIDS-defining microbes, such as Toxoplasma gondii, Pneumocystis spp., and Cryptococcus neoformans. Consequently, Streptococcus pneumoniae was categorized as an "opportunist" in persons with HIV/AIDS, despite the fact that this bacterium causes disease in apparently immunologically normal adults and children.…”

mentioning

confidence: 99%

What Is a Host? Incorporating the Microbiota into the Damage-Response Framework

Casadevall

Pirofski

2015

Infect Immun

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Since proof of the germ theory of disease in the late 19th century, a major focus of the fields of microbiology and infectious diseases has been to seek differences between pathogenic and nonpathogenic microbes and the role that the host plays in microbial pathogenesis. Remarkably, despite the increasing recognition that host immunity plays a role in microbial pathogenesis, there has been little discussion about what constitutes a host. Historically, hosts have been viewed in the context of their fitness or immunological status and characterized by adjectives such as immune, immunocompetent, immunosuppressed, immunocompromised, or immunologically impaired. However, in recent years it has become apparent that the microbiota has profound effects on host homeostasis and susceptibility to microbial diseases in addition to its effects on host immunity. This raises the question of how to incorporate the microbiota into defining a host. This definitional problem is further complicated because neither host nor microbial properties are adequate to predict the outcome of host-microbe interaction because this outcome exhibits emergent properties. In this essay, we revisit the damage-response framework (DRF) of microbial pathogenesis and demonstrate how it can incorporate the rapidly accumulating information being generated by the microbiome revolution. We use the tenets of the DRF to put forth the following definition of a host: a host is an entity that houses an associated microbiome/microbiota and interacts with microbes such that the outcome results in damage, benefit, or indifference, thus resulting in the states of symbiosis, colonization, commensalism, latency, and disease.

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“…Bacterial pneumonia and other bacterial infections were the most common causes of admission, as described in other HIV-transmission categories [36]. Pneumococcal vaccination is a reasonable prevention strategy for patients infected with HIV at all stages of immunodeficiency, and efforts should be directed towards improving vaccination levels among HIV-IDU [36].…”

Section: Discussionmentioning

confidence: 99%

“…Pneumococcal vaccination is a reasonable prevention strategy for patients infected with HIV at all stages of immunodeficiency, and efforts should be directed towards improving vaccination levels among HIV-IDU [36]. …”

Section: Discussionmentioning

confidence: 99%