Clinics in chest medicine
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With AIDS has come a new level of T-cell immunosuppression, beyond that previously seen. The impact of the HIV pandemic on the field of fungal infections includes a major increase in the number of serious fungal infections, an increase in the severity of those infections, and even some entirely new manifestations of fungal illness. ⋯ T-cell opportunists including Cryptococcus neoformans and the endemic mycoses are the most important pathogens. Phagocyte opportunists, including Aspergillus species and agents of mucormycosis, are less important.
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This article covers a selected group of topics dealing with the contribution of lung immunocompetent cells in the host defense mechanisms against HIV. These include recent findings suggesting that bidirectional signals between alveolar macrophages and pulmonary cytotoxic T lymphocytes define regulatory networks, which contribute to the accumulation of HIV-specific effector cells in the lung microenvironment. The authors also emphasize the cell pattern of HIV infection in the lung, highlighting the role of the retrovirus in weakening pulmonary host defenses and its spreading into the lower respiratory tract.