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Thoracic diseases associated with HIV infection in the era of antiretroviral therapy: clinical and imaging findings.
[primary effusion lymphoma]
The
human
immunodeficiency
virus
(
HIV
)
and
acquired
immunodeficiency
syndrome
(
AIDS
)
pandemic
has
entered
its
4
th
decade
.
Since
the
introduction
of
combination
antiretroviral
therapy
(
ART
)
in
1996
,
the
number
of
AIDS-related
deaths
has
plateaued
worldwide
.
Today
,
owing
to
the
effectiveness
of
ART
,
the
HIV-infected
population
is
aging
and
HIV
infection
has
become
a
chronic
illness
.
Non-
AIDS
comorbidities
are
increasing
,
and
the
spectrum
of
HIV-related
thoracic
diseases
is
evolving
.
In
developed
countries
,
bacterial
pneumonia
has
become
more
common
than
Pneumocystis
pneumonia
.
Its
imaging
appearance
depends
on
the
responsible
organism
,
most
commonly
Streptococcus
pneumoniae
.
Mycobacterium
tuberculosis
continues
to
be
a
major
threat
.
Its
imaging
patterns
vary
depending
on
CD
4
count
.
Primary
lung
cancer
and
Hodgkin
lymphoma
are
two
important
non-
AIDS-defining
malignancies
that
are
increasingly
encountered
at
chest
imaging
.
Human
herpesvirus
8
,
also
known
as
Kaposi
sarcoma
-associated
herpesvirus
(
KSHV
)
,
is
strongly
linked
to
HIV-related
diseases
,
including
Kaposi
sarcoma
,
multicentric
Castleman
disease
,
KSHV
inflammatory
cytokine
syndrome
,
and
primary
effusion
lymphoma
.
Immune
reconstitution
inflammatory
syndrome
is
a
direct
complication
of
ART
whose
manifestations
vary
with
the
underlying
disease
.
Given
the
high
rate
of
smoking
among
HIV-infected
patients
,
chronic
obstructive
pulmonary
disease
is
another
important
cause
of
morbidity
and
mortality
.
A
high
degree
of
suspicion
is
required
for
the
early
diagnosis
of
pulmonary
arterial
hypertension
and
lymphocytic
interstitial
pneumonia
,
given
their
nonspecific
manifestations
.
Finally
,
multilocular
thymic
cyst
manifests
as
a
cystic
anterior
mediastinal
mass
.
Recognition
of
the
clinical
and
radiologic
manifestations
of
these
less
traditional
HIV-related
diseases
can
expedite
diagnosis
and
treatment
in
the
ART
era
.
Diseases
Validation
Diseases presenting
"art whose manifestations"
symptom
primary effusion lymphoma
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