Seminars in respiratory infections
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Infection with the human immunodeficiency virus (HIV) produces profound alterations in host defense mechanisms throughout the respiratory tract. The extent of alteration of specific defenses varies with the stage or duration of HIV infection in the host. In the upper respiratory tract, HIV-infected individuals have decreased concentrations of salivary immunoglobulin A, which may predispose to colonization of the oropharynx with pathogenic microorganisms. ⋯ B lymphocytes from HIV-infected persons show deficient production of opsonizing antibodies, which may predispose to bacterial pneumonias. Defective responses of polymorphonuclear leukocytes in the lung are also likely to contribute to impaired host responses. Collectively, these multiple defects in the defense mechanisms of the respiratory tract explain the unique susceptibility of the HIV-infected host for opportunistic pulmonary infections.