PLEURAL DISEASE IN PATIENTS WITH ACQUIRED IMMUNE DEFICIENCY SYNDROME - 09/09/11

Although progressive depletion of CD4 lymphocytes is an immunologic hallmark of human immunodeficiency virus (HIV) infection, multiple impairments in host defense occur in the lungs of HIV-infected individuals.<sup>42Newbury R.L., Beck J.M. Pulmonary immunology in HIV-infected individuals Semin Respir Crit Care Med 1995 ;  16 : 161

Cliquez ici pour aller à la section Références</sup> Because the host defense functions of lymphocytes, macrophages, and neutrophils are impaired, HIV-infected individuals are susceptible to a variety of infectious and neoplastic pulmonary processes. Few investigations have focused on host defense in the pleural space during HIV infection, but the pleural diseases that occur in HIV-infected individuals indicate that pleural host defenses are also impaired.

The recent introduction of protease inhibitors, in addition to previously developed antiretroviral therapies, has already increased survival of HIV-infected individuals. That enhanced survival, however, continues to require diagnosis and treatment of the pleural complications of HIV infection.<sup>23Hamm H., Matthys H. Pleural disease in patients with AIDS Curr Opin Pulm Med 1997 ;  3 : 315

Cliquez ici pour aller à la section Références</sup> As expected, the incidence of pleural disease in HIV-infected individuals closely follows the incidence of underlying pulmonary infections and neoplasms, and series reported from developed countries differ markedly from series reported from developing countries. This review considers the common causes of pleural disease in HIV-infected individuals, focusing on recently published clinical series and selected case reports. Using the information presented here, the clinician can plan a rational approach to diagnostic tests and therapies for HIV-related pleural effusions and pneumothoraces.