HIV, pseudomonas, Bronchiolitis obliterans

Question

I have a HIV positive friend that has just been dignosed (using bronchoscopy)with:

  1. Pseudomonas infection of the lungs and,
  2. Bronchiolitis obliterans OR KS (to be confirmed with open lung biopsy) of the lungs.

My questions are:

1)How, in your experience, is psudomonas most effectively treated? 2)Have you ever had any experience of the development of bronchiolitis obliterans in HIV-infected people? 3)The treatment for bronchiolitis obliterans is high doses of steroids. Will not this make his (presently controlled) HIV start to replicate again, causing immune damage? 4)Are there any protocols which state how bronchiolitis obliterans should be treated in HIV-infected individuals so that the chances of developing pneumonia and thrush etc (due to the steroids) are minimised?

I am VERY grateful for your information.

Answer

Pseudomonas is treated by a combination of 2 antibiotics, at least one of which is given intravenously. Bronchiolitis obliterans and bronchiolitis obliterans with organizing pneumonia, or BOOP for short, have been described in HIV+s. These problems are treated the same in HIV+s and HIV-s; there is no specific separate protocol for treating this in HIV+s. If your friend's HIV is well-controlled, the steroid treatment shouldn't cause any immune damage.