Lange C, Schaaf B, Dalhoff K
Medizinische Klinik, Forschungszentrum Borstel.
Pneumologie. 2004 Jun;58(6):416-27. doi: 10.1055/s-2004-818502.
HIV-infection is characterized by a progressive immunodeficiency that predisposes affected persons to opportunistic infections and neoplasias. Pulmonary co-infections play a key role in HIV-infection as the airways are constantly exposed to aerosolized microorganisms during ventilation. In addition to the spectrum of microorganisms that are responsible for the development of community acquired pneumonia in immunocompetent hosts, persons with HIV-infection are vulnerable to infections with organisms that profit from the progressive cellular immune defects. Examples are infections with Pneumocystis jirovecii, non-tuberculous mycobacteria and viral pathogens. In contrast, tuberculosis can occur in all stages of HIV-infection. Following the HIV-pandemic, the incidence of tuberculosis has increased again in many areas of the world. The advent of antiretroviral therapies (ART) in recent years had resulted in a dramatic decrease of HIV-related morbidity and mortality in industrialized countries. As a result of the reconstitution of the immune-system under ARTs the incidence of pulmonary co-infections has also declined substantially in persons living with HIV in countries where these therapies are available.
HIV感染的特征是进行性免疫缺陷，使感染者易患机会性感染和肿瘤。肺部合并感染在HIV感染中起关键作用，因为在通气过程中气道不断暴露于雾化的微生物。除了在免疫功能正常宿主中导致社区获得性肺炎的微生物谱外，HIV感染者还易受利用进行性细胞免疫缺陷的生物体感染。例如，感染耶氏肺孢子菌、非结核分枝杆菌和病毒病原体。相比之下，结核病可发生在HIV感染的所有阶段。随着HIV大流行，世界许多地区的结核病发病率再次上升。近年来抗逆转录病毒疗法（ART）的出现，使工业化国家中与HIV相关的发病率和死亡率大幅下降。由于在ART治疗下免疫系统的重建，在可获得这些疗法的国家，HIV感染者中肺部合并感染的发病率也大幅下降。
