This chapter discusses the pulmonary complications of human immunodeficiency virus (HIV) infection in populations with access to highly active antiretroviral therapy (HAART), while acknowledging that the large burden of HIV disease exists in the developing world. With increasing availability of prophylaxis and HAART in currently resource-poor nations, however, the pulmonary and other complications of HIV infection more closely resemble those seen in developed nations. Pulmonary diseases are common complications of infection with HIV. These include both opportunistic infections, such as pneumocystis carinii pneumonia (PCP), as well as other complications such as Kaposi's sarcoma (KS), non-Hodgkin's lymphoma (NHL), and changes in pulmonary function. It is noted that widespread use of HAART has had a significant impact on the epidemiology of HIV-associated opportunistic infections. Overall, there has been a substantial decline in the incidence of PCP, community acquired pneumonia, and other pulmonary complications of advanced HIV disease in populations with access to HAART.
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