I. Introduction

Bacterial infections have been recognized as an important cause of morbidity during HIV infection for many years.^(1-4) With improvements in patient survival and successful prophylaxis of opportunistic infections, bacterial infections are emerging as a more frequent complication of advanced HIV disease.⁽⁵⁾ Bacterial pneumonia and sepsis frequently lead to hospitalization of HIV-infected patients and in one series were the leading cause of death.⁽⁶⁾ In 1993 recurrent bacterial pneumonia was added as an AIDS-defining condition in the expanded AIDS case definition. Among injection drug users, bacterial pneumonia and sepsis have been shown to be a major cause of morbidity prior to an AIDS diagnosis as well as a predictor of progression to AIDS.^{(7, 8)} This chapter will review recent data on the epidemiology, pathogenesis, clinical spectrum, and prevention of selected HIV-associated bacterial infections. The exclusion of mycobacterial infections, gastrointestinal bacterial infections, and sexually transmitted bacterial pathogens is not meant to diminish the importance of these agents.