Other diseases which come with HIV infection

1. HIV Opportunistic infections
Dr kyazze

2. EFFECTS OF HIV ON BODY
SYSTEMS

7. Diseases of the hematopoetic
/Lymphatic system

13. Common opportunistic infections

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PCP: Diagnosis (2)
 CXR: various presentations
 May be normal in early disease
 Typical: diffuse bilateral, symmetrical
interstitial infiltrates
 May see atypical presentations, including
nodules, asymmetric disease, blebs, cysts,
pneumothorax
 Cavitation, intrathoracic adenopathy, and
pleural effusion are uncommon (unless
caused by a second concurrent process)

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PCP: Diagnosis (3)
 Chest CT, thin-section
 Patchy ground-glass attenuation
 May be normal
 Gallium scan
 Pulmonary uptake

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PCP: Diagnosis (Imaging)
Chest X ray: PCP with bilateral, diffuse
granular opacities
Credit: L. Huang, MD; HIV InSite
Chest X ray: PCP with bilateral perihilar
opacities, interstitial prominence, hyperlucent
cystic lesions
Credit: HIV Web Study, www.hivwebstudy.
org, © 2006 University of Washington

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PCP: Diagnosis (Imaging) (2)
High-resolution computed tomograph (HRCT) scan of the chest showing
PCP. Bilateral patchy areas of ground-glass opacity are suggestive of PCP.
Credit: L. Huang, MD; HIV InSite

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PCP: Diagnosis
 Definitive diagnosis requires demonstrating
organism:
 Induced sputum (sensitivity <50% to >90%)
 Spontaneously expectorated sputum: low sensitivity
 Bronchoscopy with bronchoalveolar lavage
(sensitivity 90-99%)
 Transbronchial biopsy (sensitivity 95-100%)
 Open-lung biopsy (sensitivity 95-100%)
 PCR: high sensitivity for BAL sample; may not
distinguish disease from colonization

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PCP: Diagnosis (Histopathology)
Lung biopsy using silver stain to demonstrate P jiroveci
organisms in tissue
Credit: A. Ammann, MD; UCSF Center for HIV Information
Image Library

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PCP: Diagnosis
 Treatment may be initiated before
definitive diagnosis is established
 Organism persists for days/weeks after
start of treatment

40. Severity Alveolar to
arterial oxygen
difference
Partial pressure
of oxygen
mild <35 >70
Moderate 35 to 45 <70
severe > 45 <50

59. Treatment