REVIEW

Lymphocytic interstitial pneumonitis in HIV infected adults

S Das¹ and R F Miller²

¹ Department of Genitourinary and HIV Medicine, Whittall Street Clinic, Whittall Street, Birmingham B4 6DH, UK
² Department of Sexually Transmitted Diseases, Windeyer Institute of Medical Sciences, Royal Free and University College Medical School and Camden Primary Care Trust, Mortimer Market Centre, Mortimer Market, London WC1E 6AU, UK

Correspondence to:
Correspondence to:
Dr R Miller, Department of Sexually Transmitted Diseases, Windeyer Institute of Medical Sciences, Royal Free and University College Medical School and Camden Primary Care Trust, Mortimer Market Centre, Mortimer Market, London WC1E 6AU, UK;
rmiller{at}gum.ucl.ac.uk

Objectives: To describe current knowledge on the aetiology, pathology, presentation, diagnosis, and treatment of lymphocytic interstitial pneumonitis in HIV infected adults.

Methods: A Medline search was performed using the key words "HIV," "pneumonitis," and "lymphocytes." A further search was performed with the MESH heading "interstitial lung disorders." Related articles were also searched using Pubmed.

Results: Lymphocytic interstitial pneumonitis is a common complication in HIV infected children. In adults it is uncommon and is described most commonly among black African and Afro-Caribbean patients. The aetiology and pathogenesis of lymphocytic interstitial pneumonitis in HIV infection is not clear. The clinical and radiological presentations may be indistinguishable from Pneumocystis carinii infection and a lung biopsy is necessary to establish the diagnosis. Recent evidence suggests that lymphocytic interstitial pneumonitis in HIV infected patients may respond to combination antiretroviral therapy with dramatic improvements in clinical and radiological abnormalities.

Conclusion: Lymphocytic interstitial pneumonitis in HIV infected patients is a treatable condition. This condition should be considered in HIV infected patients presenting with respiratory symptoms as they may gain considerable benefit from antiretroviral therapy.

Keywords: HIV; pneumonitis; antiretroviral therapy; lymphocytes; glucocorticoids

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