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Severe airflow obstruction in vertically acquired HIV infection.

Calligaro GL, Esmail A, Gray DM - Respirol Case Rep (2014)

Bottom Line: In the majority of patients the etiology of this obstructive ventilatory defect is multifactorial.Post-infectious obliterative bronchiolitis, post-tuberculous lung damage (including bronchiectasis), immune reconstitution and the direct effects of HIV viral infection may all play a role.With increases in life expectancy and decreases in infectious complications in patients taking antiretroviral medications, the importance of HIV-associated chronic lung disease as a cause of pulmonary disability is likely to increase.

View Article: PubMed Central - PubMed

Affiliation: Division of Pulmonology, Department of Medicine, Groote Schuur Hospital and UCT Lung Institute, University of Cape Town Cape Town, South Africa.

ABSTRACT
It is becoming increasingly clear that human immunodeficiency virus (HIV) infection, either independently or in concert with opportunistic infections like pulmonary tuberculosis, is a risk factor for the development of chronic airflow limitation. In the majority of patients the etiology of this obstructive ventilatory defect is multifactorial. Post-infectious obliterative bronchiolitis, post-tuberculous lung damage (including bronchiectasis), immune reconstitution and the direct effects of HIV viral infection may all play a role. With increases in life expectancy and decreases in infectious complications in patients taking antiretroviral medications, the importance of HIV-associated chronic lung disease as a cause of pulmonary disability is likely to increase. This is particularly relevant in regions like sub-Saharan Africa, where both HIV infection and tuberculosis are highly prevalent. Here, to illustrate the complexity of this interaction, we present the case of a 15-year-old girl with vertically acquired HIV infection, multiple episodes of pulmonary infection, and severe airflow obstruction.

No MeSH data available.


Related in: MedlinePlus

High-resolution computed tomography of the chest showing bilateral cylindrical and saccular bronchiectasis with mosaic attenuation. The areas of low attenuation showed little change in cross-sectional area during expiration, and also did not show the normal increase in attenuation, confirming gas trapping (expiratory sequence not shown here).
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fig02: High-resolution computed tomography of the chest showing bilateral cylindrical and saccular bronchiectasis with mosaic attenuation. The areas of low attenuation showed little change in cross-sectional area during expiration, and also did not show the normal increase in attenuation, confirming gas trapping (expiratory sequence not shown here).

Mentions: The chest radiograph showed hyperlucency of the left lung with multiple cystic shadows in the lower zones bilaterally (Fig. 1). The high-resolution computed tomography of the chest confirmed bilateral cylindrical and saccular bronchiectasis, with mosaic attenuation and gas trapping on expiratory views (Fig. 2). She had a recent CD4 count of 406 cells/milliliter and a suppressed HIV viral load. Sputum cultured a sensitive H. influenzae; Xpert® (Cepheid Inc., Sunnyvale, CA, USA) MTB/RIF and culture for M. tuberculosis were negative.


Severe airflow obstruction in vertically acquired HIV infection.

Calligaro GL, Esmail A, Gray DM - Respirol Case Rep (2014)

High-resolution computed tomography of the chest showing bilateral cylindrical and saccular bronchiectasis with mosaic attenuation. The areas of low attenuation showed little change in cross-sectional area during expiration, and also did not show the normal increase in attenuation, confirming gas trapping (expiratory sequence not shown here).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4263494&req=5

fig02: High-resolution computed tomography of the chest showing bilateral cylindrical and saccular bronchiectasis with mosaic attenuation. The areas of low attenuation showed little change in cross-sectional area during expiration, and also did not show the normal increase in attenuation, confirming gas trapping (expiratory sequence not shown here).
Mentions: The chest radiograph showed hyperlucency of the left lung with multiple cystic shadows in the lower zones bilaterally (Fig. 1). The high-resolution computed tomography of the chest confirmed bilateral cylindrical and saccular bronchiectasis, with mosaic attenuation and gas trapping on expiratory views (Fig. 2). She had a recent CD4 count of 406 cells/milliliter and a suppressed HIV viral load. Sputum cultured a sensitive H. influenzae; Xpert® (Cepheid Inc., Sunnyvale, CA, USA) MTB/RIF and culture for M. tuberculosis were negative.

Bottom Line: In the majority of patients the etiology of this obstructive ventilatory defect is multifactorial.Post-infectious obliterative bronchiolitis, post-tuberculous lung damage (including bronchiectasis), immune reconstitution and the direct effects of HIV viral infection may all play a role.With increases in life expectancy and decreases in infectious complications in patients taking antiretroviral medications, the importance of HIV-associated chronic lung disease as a cause of pulmonary disability is likely to increase.

View Article: PubMed Central - PubMed

Affiliation: Division of Pulmonology, Department of Medicine, Groote Schuur Hospital and UCT Lung Institute, University of Cape Town Cape Town, South Africa.

ABSTRACT
It is becoming increasingly clear that human immunodeficiency virus (HIV) infection, either independently or in concert with opportunistic infections like pulmonary tuberculosis, is a risk factor for the development of chronic airflow limitation. In the majority of patients the etiology of this obstructive ventilatory defect is multifactorial. Post-infectious obliterative bronchiolitis, post-tuberculous lung damage (including bronchiectasis), immune reconstitution and the direct effects of HIV viral infection may all play a role. With increases in life expectancy and decreases in infectious complications in patients taking antiretroviral medications, the importance of HIV-associated chronic lung disease as a cause of pulmonary disability is likely to increase. This is particularly relevant in regions like sub-Saharan Africa, where both HIV infection and tuberculosis are highly prevalent. Here, to illustrate the complexity of this interaction, we present the case of a 15-year-old girl with vertically acquired HIV infection, multiple episodes of pulmonary infection, and severe airflow obstruction.

No MeSH data available.


Related in: MedlinePlus