Hypersensitivity Pneumonitis in HIV/AIDS Patients

Diagnostic Considerations

• In patients with CD4+ counts <200 cells/μL, Pneumocystis pneumonia, tuberculosis, and other opportunistic infections are far more likely causes of interstitial infiltrates, and infectious etiologies must be systematically excluded before diagnosing hypersensitivity pneumonitis, according to the Centers for Disease Control and Prevention 1
• Bacterial pneumonia, particularly Streptococcus pneumoniae and Haemophilus species, remains the most common cause of pneumonia across all CD4+ counts in HIV patients, as reported by the Centers for Disease Control and Prevention 2, 3
• Atypical pathogens including Legionella pneumophila, Mycoplasma pneumoniae, and Chlamydophila species should be considered before hypersensitivity pneumonitis, as recommended by the Centers for Disease Control and Prevention 2, 5