British HIV Association guidelines on the management of opportunistic infection in people living with HIV:
The clinical management of pulmonary opportunistic infections 2024
With improvements in the HIV testing and treatment cascade and reductions in the prevalence of advanced HIV, the incidence of ‘classic’ pulmonary opportunistic infections is lower, and so less frequently encountered by physicians. In addition, chronic lung diseases such as chronic obstructive pulmonary disease have become more common in people living with HIV taking antiretroviral therapy.
HIV continues to alter the lung environment through the impact of persistent viral replication, inflammation, oxidative stress, alterations in the microbiome and the modifiable effects of cigarette smoking. This means that the relative contribution of common community-acquired respiratory infections is greater and these can present with more severe disease necessitating different approaches to prevention compared with individuals without HIV. Accordingly, as well as pneumonia caused by Pneumocystis jirovecii, in these guidelines we consider bacterial pneumonia and influenza. Fungal pneumonias and cytomegalovirus, the incidence rates of which are low, are also considered. Each section contains specific information about the epidemiology, presentation, treatment and prophylaxis of opportunistic infections.
Supporting people living with HIV and opportunistic infections
Declaration of interests
Declaration of interests from writing group members
The consultation closed on Monday 12 February 2024.