Pulmonary complications of AIDS: radiologic features

Cohen, Burton A.; Pomeranz, Stephen J.; Jg, Rabinowitz; Mj, Rosen; Train, J S; Norton, KI; Ds, Mendelson

doi:10.2214/ajr.143.1.115

Cited by 71 publications

(18 citation statements)

References 6 publications

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“…1-4 Chronic lung diseases and other co-morbid non-AIDS conditions are now associated with a relatively increased number of deaths in persons with HIV as life expectancy increases due to improved HIV treatment and education. 5-9 Numerous publications have provided pictorial essays illustrating common radiographic findings related to the lung and HIV infection or AIDS.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors Associated With Quantitative Evidence of Lung Emphysema and Fibrosis in an HIV-Infected Cohort

Leader

Crothers

Huang

et al. 2016

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Introduction The disease spectrum for HIV-infected individuals has shifted towards co-morbid non-AIDS conditions including chronic lung disease, but quantitative image analysis of lung disease has not been performed. Objectives To quantify the prevalence of structural changes of the lung indicating emphysema or fibrosis on radiographic examination. Methods A cross-sectional analysis of 510 HIV-infected participants in the multi-center Lung-HIV study was performed. Data collected included: demographics, biological markers of HIV, pulmonary function testing, and chest CT examinations. Emphysema and fibrosis-like changes were quantified on CT images based on threshold approaches. Results In our cohort: 69% was on antiretroviral therapy, 13% had a current CD4 cell count less than 200 cells/μL, 39% had an HIV viral load greater than 500 copies/mL, 25% had at least a trace level of emphysema (defined as >2.5% of voxels <-950HU). Trace emphysema was significantly correlated with age, smoking, and pulmonary function. Neither current CD4 cell count nor HIV viral load was significantly correlated with emphysema. Fibrosis-like changes were detected in 29% of the participants and were significantly correlated with HIV viral load (Pearson correlation coefficient = 0.210, p<0.05); current CD4 cell count was not associated with fibrosis. In multivariable analyses including age, race, and smoking status, HIV viral load remained significantly correlated with fibrosis-like changes (coefficient = 0.107, P = 0.03). Conclusion A higher HIV viral load was significantly associated with fibrosis-like changes possibly indicating early interstitial lung disease, but emphysematous changes were not related to current CD4 cell count or HIV viral load.

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Section: Introductionmentioning

confidence: 99%

Risk Factors Associated With Quantitative Evidence of Lung Emphysema and Fibrosis in an HIV-Infected Cohort

Leader

Crothers

Huang

et al. 2016

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…Several HIV-infected pa¬ tients with Toxoplasma pneumonitis have been described26; however, all but one of these patients had CNS involvement. A recently published series from France described 13 HIV-infected patients with T gondii pneumonia, 10 Table. Bronchoalveolar lavage (BAL) fluid specimens and pleural fluids were concentrated by centrifugation, smears were made from the sediment, staining was performed with a modified rapid Giemsa stain (Diff-Quik, American Scientific Products, Chicago, 111), and specimens were examined microscopically, as previously described.9 Touch preparations made from transbronchial biopsy specimens were stained with the same modi¬ fied rapid Giemsa stain and examined microscopically, as previ¬ ously described.9 All specimens were routinely examined for bacteria, fungi, and mycobacteria by special stains and cultures. Biopsy specimens and BAL fluid specimens underwent histo¬ logie and cytologie examination.…”

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confidence: 99%

Toxoplasma gondii Pneumonitis in Patients Infected With the Human Immunodeficiency Virus

Schnapp

Geaghan²,

Campagna³

et al. 1992

Arch Intern Med

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Pulmonary toxoplasmosis is a rarely recognized opportunistic infection in immunocompromised patients. A few case reports have described pulmonary toxoplasmosis in human immunodeficiency virus-infected patients in association with Toxoplasma gondii central nervous system disease. We encountered six cases of pulmonary toxoplasmosis in human immunodeficiency virus-infected patients who presented with a protracted febrile illness, respiratory symptoms, and an abnormal chest roentgenogram in the absence of neurologic findings. No clinical or roentgenographic features distinguished T gondii pneumonitis from more common opportunistic pulmonary infections. As the acquired immunodeficiency syndrome epidemic progresses, the presenting illnesses have evolved. Toxoplasma gondii must be considered a potential cause of pulmonary disease during the evaluation of human immunodeficiency virus-infected patients with respiratory symptoms.

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“…Biopsy-proven PCP in the presence of normal/almost normal chest radiographs in AIDS patients have been described by others (2,5,7). In earlier published investigations the etiologic agent was demonstrated by BAL and/or lung biopsy, and several authors (2, 4, 5, 8) empha- size the importance of this procedure early in the course of interstitial pneumonia in immunocompromized patients.…”

Section: Discussionmentioning

confidence: 86%

Computed Tomography of the Lungs in Acquired Immunodeficiency Syndrome

Hartelius¹,

Gaub²,

Jensen³

et al. 1988

Acta Radiol

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Computed tomography of the chest was performed on 42 occasions as part of the diagnostic work-up in 26 homosexual men with, or suspected of the acquired immunodeficiency syndrome (AIDS). In 17 cases both the chest radiographs and the lung scans were abnormal, and bronchoscopy and/or lung biopsy established an etiologic diagnosis in the majority of these cases. In 9 cases CT of the lungs revealed unequivocal interstitial infiltration in the presence of a normal chest radiograph, and subsequently an etiologic agent was demonstrated in all these cases. In 9 cases, patients with symptoms indicative of pulmonary infection had both a normal chest radiograph and a normal lung scan, and in none of these cases did the clinical course or additional diagnostic procedures indicate the presence of current opportunistic lung infection. CT of the lungs seems to identify accurately those patients with severe HIV-related diseases in whom invasive diagnostic procedures such as bronchoalveolar lavage and/or lung biospy should be done.

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Pulmonary complications of AIDS: radiologic features

Cited by 71 publications

References 6 publications

Risk Factors Associated With Quantitative Evidence of Lung Emphysema and Fibrosis in an HIV-Infected Cohort

Risk Factors Associated With Quantitative Evidence of Lung Emphysema and Fibrosis in an HIV-Infected Cohort

Toxoplasma gondii Pneumonitis in Patients Infected With the Human Immunodeficiency Virus

Computed Tomography of the Lungs in Acquired Immunodeficiency Syndrome

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