Pneumonias and HIV

Table of Contents

• What Is Pneumonia?
• Pneumonia and HIV
• Pneumocystis (jiroveci) Pneumonia (PCP)
• Bacterial Pneumonias
• Viral Pneumonias
• Tuberculosis (TB)
• Other (Rare) Cases of Pneumonia in People Living With HIV
• Conclusion

What Is Pneumonia?

Pneumonia refers to a common infection of the lungs caused by one of the following types of germs: bacteria, fungi, or viruses. The infection can involve one lung, both lungs, or just part of a lung. Depending on your overall health, pneumonia and its symptoms can be mild or severe. In more severe cases, pneumonia can require hospitalization and even lead to death. In the US, 1.1 million people were hospitalized with pneumonia in 2013, and over 53,000 died from the disease. Worldwide, pneumonia is the leading cause of death for children under the age of five. Almost one fifth of all deaths of children under the age of five are due to pneumonia each year.

The symptoms, diagnoses, and treatments listed in this section are broad symptoms common to all types of pneumonia. Some symptoms, like cough with sputum, are characteristic of only certain types of pneumonia (e.g., bacterial pneumonias). Similarly, some treatments, like antibiotics, are indicated for only some types of pneumonia (e.g., bacterial pneumonias, Pneumocystis pneumonia) and not for others (e.g., viral pneumonias). For information specific to each type of pneumonia, please scroll down.

Symptoms

• Shortness of breath
• Cough with sputum (materials such as mucus and phlegm that are coughed up from the lungs)
• Dry cough (no mucus or phlegm with coughing)
• Fatigue
• Fever
• Chills

Diagnosis

• Physical exam of the lungs with a stethoscope
• Chest X-ray
• Sputum, or mucus samples for stain and culture, which show what germ is present in the lungs. Sometimes a person can cough up the sputum. If not, a procedure known as bronchoalveolar lavage (BAL) can be done. In this procedure, sputum is obtained by placing a small tube down the windpipe that enables the provider to see the inside of the lungs and collect a sample of sputum.
• Arterial blood gases (ABGs) are drawn to measure oxygen content; the lower the amount of oxygen in the bloodstream, the more serious the pneumonia

Treatment

• Antibiotics (if caused by bacteria)
• Oxygen (if oxygen levels are low)
• Rest
• Fluids
• Other medicines to help make breathing easier
• When pneumonia is severe, a person may not be able to breathe on her/his own. When this happens, a machine called a respirator (or ventilator) is used temporarily while the antibiotics fight the infection and improve breathing.

Prevention

There are many simple things you can do to avoid getting infected with the germs that cause pneumonia. These include washing your hands regularly, cleaning surfaces that are touched often and by many different people (countertops, phones, doorknobs), and coughing or sneezing into a tissue or your elbow or sleeve. You can also prevent pneumonia by stopping or reducing smoking, limiting the time you spend in or around smoke, and by getting vaccinated when appropriate. There are several vaccines that can prevent infection with the bacteria or viruses that cause pneumonia:

• Influenza (flu) vaccine
• Pneumococcus vaccine
• Measles
• Pertussis (whooping cough)
• Varicella (chicken pox)
• Haemophilus influenzae type b (Hib)

Pneumonia and HIV

People living with HIV (HIV+) are more vulnerable to pneumonias of all kinds because they have a weakened immune system. Certain pneumonias lead to an AIDS diagnosis, such as Pneumocystis (PCP), recurrent pneumonia (more than once in a year's time), and active tuberculosis (TB).