Huang Laurence, Crothers Kristina
Division of Pulmonary, Department of Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, CA 94110, USA.
Respirology. 2009 May;14(4):474-85. doi: 10.1111/j.1440-1843.2009.01534.x.
Among the HIV-associated pulmonary complications, opportunistic pneumonias are major causes of morbidity and mortality. The spectrum of HIV-associated opportunistic pneumonias is broad and includes bacterial, mycobacterial, fungal, viral and parasitic pneumonias. Bacterial pneumonia is the most frequent opportunistic pneumonia in the United States and Western Europe while tuberculosis is the dominant pathogen in sub-Saharan Africa. With the use of combination antiretroviral therapy and prophylaxis, the incidence of Pneumocystis pneumonia (PCP) has declined. Nevertheless, PCP continues to occur in persons who are unaware of their HIV infection, those who fail to access medical care, and those who fail to adhere to antiretroviral therapy or prophylaxis. Although pneumonias due to Cryptococcus neoformans, Histoplasma capsulatum, Coccidioides immitis, cytomegalovirus and Toxoplasma gondii are less frequent, their presence in the lung is often indicative of disseminated disease and is associated with significant mortality.
在与HIV相关的肺部并发症中，机会性肺炎是发病和死亡的主要原因。与HIV相关的机会性肺炎范围广泛，包括细菌性、分枝杆菌性、真菌性、病毒性和寄生虫性肺炎。在美国和西欧，细菌性肺炎是最常见的机会性肺炎，而在撒哈拉以南非洲，结核病是主要病原体。随着联合抗逆转录病毒疗法和预防措施的使用，肺孢子菌肺炎（PCP）的发病率有所下降。然而，PCP仍会发生在未意识到自己感染HIV的人、无法获得医疗护理的人以及未坚持抗逆转录病毒疗法或预防措施的人身上。尽管新型隐球菌、荚膜组织胞浆菌、粗球孢子菌、巨细胞病毒和弓形虫引起的肺炎较少见，但它们在肺部的出现往往提示播散性疾病，且与显著的死亡率相关。
