Immune reconstitution pneumonitis following Pneumocystis carinii pneumonia in HIV-infected subjects.

Abstract:

:An HIV-infected man presented with a pneumonic illness following an episode of treated Pneumocystis carinii pneumonia (PCP). He had a rise in his CD4 count from 4 to 125 cells/microL on antiretroviral therapy prior to the onset of the second respiratory event. Bronchoalveolar lavage (BAL) revealed no pathogen, although a CD4 lymphocytosis in addition to a highly unusual population of rapidly proliferating CD8 cells was demonstrated. Following 2 weeks of steroid and anti-pneumocystis therapy, a repeat bronchoscopy demonstrated that the expression of these markers had returned to low values. This second respiratory illness, which may have arisen as a consequence of the regenerating immune response reacting to residual P. carinii antigen in the lung, is apparently not rare. When we reviewed our case notes, five further individuals were identified that had started antiretroviral therapy following an episode of PCP and subsequently developed a self-limiting pneumonitis for which no pathogen was identified on bronchoscopy.

journal_name

HIV Med

journal_title

HIV medicine

authors

Barry SM,Lipman MC,Deery AR,Johnson MA,Janossy G

doi

10.1046/j.1468-1293.2002.00115.x

keywords:

subject

Has Abstract

pub_date

2002-07-01 00:00:00

pages

207-11

issue

3

eissn

1464-2662

issn

1468-1293

pii

0115

journal_volume

3

pub_type

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