Acquired Immune Deficiency Syndrome

Abstract

The acquired immune deficiency syndrome is caused by the human immunodeficiency virus (HIV) infection that causes immune system deterioration along with opportunistic infections. Lung diseases are common in children with HIV, especially recurrent infections that tend to present with fever, respiratory symptoms, increased work of breathing, and rapid progression, in contrast with noninfectious diseases that present with slow starting respiratory symptoms and have a wide range of clinical presentations. Bacterial pneumonia is the most frequent infectious entity in all stages of the disease, but its incidence has improved with highly active antiretroviral therapy (HAART) and immunizations. Tuberculosis has increased as a primary infection, but is poorly controlled, and may progress to systemic dissemination and development of extrapulmonary forms. Viral pneumonia has the same incidence as in normal children but tends to be severe with prolonged virus excretion. Cytomegalovirus is among the opportunistic agents that most commonly infect patients with acquired immune deficiency syndrome, especially those with severe immunosuppression. Pneumocystis jirovecii is the most common cause of atypical pneumonia in HIV-positive children; it can progress quickly with no treatment, even leading to respiratory failure. Chronic multifactorial lung disease used to be frequent in children, especially before HAART was introduced. Lymphocytic interstitial pneumonia used to be the most common of these entities. Some neoplasia may arise in the lung, or spread to it, such as non-Hodgkin lymphoma, Kaposi’s sarcoma, leiomyosarcoma, and Hodgkin’s lymphoma.