Elsevier

Medicina Clínica

Volume 125, Issue 14, October 2005, Pages 548-555
Medicina Clínica

Revisión
Complicaciones infecciosas pulmonares en los pacientes con infección por el virus de la inmunodeficiencia humana en la era del tratamiento antirretroviral de gran actividad en EspañaInfectious pulmonary complications in HIV-infected patients in the high by active antiretroviral therapy era in Spain

https://doi.org/10.1157/13080461Get rights and content

Las complicaciones pulmonares en los pacientes con infección por el virus de la inmunodeficiencia humana (VIH) son, actualmente, un problema de primer orden. En España son la primera causa de ingreso hospitalario de estos pacientes. Además, la mayoría experimenta alguna complicación de este tipo durante su evolución. La etiología más frecuente es la neumonía bacteriana, particularmente las producidas por neumococos; en segundo lugar, la neumonías por Pneumocystis jiroveci (anteriormente P. carinii), y en tercer lugar, las micobacterias, sobre todo la tuberculosis. Desde las primeras descripciones de complicaciones pulmonares, su epidemiología ha experimentado cambios notables. Entre las causas principales se encuentra la introducción de la profilaxis primaria frente a P. jiroveci, y más recientemente, la generalización del tratamiento antirretroviral combinado de elevada eficacia. En esta revisión se actualizan las principales causas en la actualidad de complicaciones pulmonares en los pacientes infectados por el VIH en España, su diagnóstico y pronóstico.

Pulmonary complications in HIV-infected patients are at present a first-rate problem. They are the main cause of hospital admission of these patients in our country. Most HIV-patients have a pulmonary complication during the evolution of the infection. The main etiologic diagnosis is bacterial pneumonia, especially pneumococcal pneumonia; the second most frequent cause is Pneumocystis jiroveci (previously named P. carinii) pneumonia and the third cause is mycobacteriosis, particularly Mycobacterium tuberculosis. From early studies, important changes in the epidemiology of HIV-related pulmonary complications have occurred. General prescription of P. jiroveci primary prophylaxis is probably one of the main causes, and, more recently, the use of highly active antiretroviral therapy may also be an underlying explanation. In this review, epidemiology, diagnosis and outcome of HIV-related pulmonary complications in our country are update.

Referencias bibliográficas (136)

  • K.E. Mönkemüller et al.

    Declining prevalence of opportunisc gastrointestinal disease in the era of combination antiretroviral therapy

    Am J Gastroenterol

    (2000)
  • M. Ferrer et al.

    Diagnostic value of telescoping plugged catheters in HIV-infected patients with pulmonary infiltrates

    Chest

    (1992)
  • A.J. Wolff et al.

    Pulmonary manifestations of HIV infection in the era of highly active antiretroviral therapy

    Chest

    (2001)
  • K. De Gaetano Donati et al.

    Effect of highly active antiretroviral therapy on the incidence of bacterial pneumonia in HIV-infected subjects

    Int J Antimicrob Agents

    (2000)
  • D.J. Witt et al.

    Bacterial infections in adult patients with the acquired immune deficiency syndrome (AIDS) and AIDS-related complex

    Am J Med

    (1987)
  • C. Feldman et al.

    Bacteriemic pneumococcal pneumonia in HIV-seropositive and HIVseronegative adults

    Chest

    (1999)
  • N. French et al.

    23-valent pneumococcal polysaccharide vaccine in HIV-1-infected Ugandan adults: double-blind, randomised and placebo controlled trial

    Lancet

    (2000)
  • C.C. Hung et al.

    Clinical experience of the 23-valent capsular polysaccharide pneumococcal vaccination in HIV-1-infected patients receiving highly active antiretroviral therapy: a prospective observational study

    Vaccine

    (2004)
  • B. Afessa et al.

    Bacterial pneumonia in hospitalized patients with HIV infection. The pulmonary complications, ICU support, and prognostic factors of hospitalized patients with HIV (PIP) study

    Chest

    (2000)
  • CDC. Pneumocystis carinii pneumonia –Los Angeles. MMWR. 1981;...
  • J.R. Stringer et al.

    A new name (Pneumocystis jiroveci) for pneumocystis from humans

    Emerg Infect Dis

    (2002)
  • HIV and AIDS –United States, 1981-2000

    MMWR

    (2001)
  • The global HIV and AIDS epidemic, 2001

    MMWR

    (2001)
  • ONUSIDA/OMS, 2003 Programa Conjunto de las Naciones Unidas sobre el VIH/sida (ONUSIDA). Organización Mundial de la...
  • 2004 Report on the global AIDS epidemic. Geneva: Joint United Nations Program on HIV/AIDS, July...
  • The world health report 2004. Changing history. Geneva: World Health Organization, May 2004. Disponible en:...
  • Instituto de Salud Carlos III. Centro Nacional de Epidemiología. Ministerio de Sanidad y Consumo. Dirección General de...
  • Instituto de Salud Carlos III. Centro Nacional de Epidemiología. Ministerio de Sanidad y Consumo. Dirección General de...
  • J.F. Murray et al.

    Pulmonary complications of the acquired immunodeficiency syndrome: report of a National Heart, Lung, and Blood Institute workshop

    N Engl J Med

    (1984)
  • J.F. Murray et al.

    NHLBI workshop summary. Pulmonary complications of the acquired syndrome: an update

    Am Rev Respir Dis

    (1987)
  • G.U. Meduri et al.

    Pulmonary manifestations of acquired immunodeficiency syndrome

    Clin Infect Dis

    (1992)
  • B. Afessa et al.

    Autopsy findings in HIV-infected inner city patients

    J Acquir Immune Defic Syndr

    (1992)
  • E. Masliah et al.

    Changes in pathological findings at autopsy in AIDS cases for the last 15 years

    AIDS

    (2000)
  • D.H. Osmond et al.

    Impact of bacterial pneumonia and Pneumocystis carinii pneumonia on human immunodeficiency virus disease progression

    Clin Infect Dis

    (1999)
  • J.E. Kaplan et al.

    Do bacterial pneumonia and Pneumocystis carinii pneumonia accelerate progression of human immunodeficiency virus disease?

    Clin Infect Dis

    (1999)
  • C. Whalen et al.

    Accelerated course of human immunodeficiency virus infection after tuberculosis

    Am J Crit Care Med

    (1995)
  • J. Del Amo et al.

    Impact of tuberculosis on HIV disease progression in persons with well-documented time of HIV seroconversion

    J Acquir Immune Defic Syndr

    (2003)
  • J.M. Wallace et al.

    Respiratory illness in persons with human immunodeficiency virus infection

    Am Rev Respir Dis

    (1993)
  • J.M. Wallace et al.

    Respiratory disease trends in the pulmonary complications of HIV infection study cohort

    Am J Respir Crit Care Med

    (1997)
  • C.L. Daley et al.

    Pulmonary complications of HIV infection in Dar es Salaam, Tanzania. Role of bronchoscopy and bronchoalveolar lavage

    Am J Respir Crit Care Med

    (1996)
  • S.H. Salzman

    Bronchoscopic and other invasive sampling techniques in the diagnosis of pulmonary complications of HIV infection

  • D. Serraino et al.

    Epidemiological aspects of major opportunistic infections of the respiratory tract in persons with AIDS: Europe, 1993-2000

    AIDS

    (2003)
  • G. Kamanfu et al.

    Pulmonary complications of human immunodeficiency virus infection in Bujumbura, Burundi

    Am Rev Respir Dis

    (1993)
  • S. Lucas et al.

    Absence of pneumocystosis in Ugandan AIDS patients

    AIDS

    (1989)
  • J. Batungwanayo et al.

    Pulmonary disease associated with the human immunodeficiency virus in Kigali, Rwanda

    Am J Respir Crit Care Med

    (1994)
  • Guidelines for prophylaxis against Pneumocystis carinii pneumonia for persons infected with human immunodeficiency virus

    MMWR

    (1989)
  • A. Muñoz et al.

    Trends in the incidence of outcomes defining acquired immunodeficiency syndrome (AIDS) in the Multicenter AIDS Cohort Study: 1985-1991

    Am J Epidemiol

    (1993)
  • W.D. Hardy et al.

    A controlled trial of trimethoprim-sulfamethoxazole or aerosolized pentamidine for secondary prophylaxis of Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome. AIDS Clinical Trials Group Protocol 021

    N Engl J Med

    (1992)
  • S.R. Tabet et al.

    Bacterial infections in adult patients hospitalized with AIDS: case-control study of prophylactic efficay of trimethoprim-sulfamethoxazole versus aerosolized pentamidine

    Int J STD AIDS

    (1997)
  • M.D. Edge et al.

    Community-acquired bacteremia in HIV-positive patients: protective benefit of co-trimoxazole

    AIDS

    (1996)
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