Resolution of Lymphocytic Interstitial Pneumonia in a Human Immunodeficiency Virus-infected Adult Following the Start of Highly Active Antiretroviral Therapy

Abstract

A case of human immunodeficiency virus (HIV)-associated lymphocytic interstitial pneumonia is described, in which improvement occurred soon after starting antiviral therapy. A 20-y-old black female with HIV infection (CD4⁺ count 228×10⁶ cells and plasma viral load 379,670 copies/ml) showed radiological signs of reticulonodular infiltrates of the lungs and pulmonary functional tests indicative of a severe restrictive syndrome. Bronchoalveolar and blood cultures yielded no organism and transbronchial biopsy disclosed findings consistent with lymphocytic interstitial pneumonia. After 4 weeks on triple HIV combination therapy, she was well and respiratory tests had normalized. Six months later, a computed tomographic scan of the chest showed only residual alterations. Despite a good virological response to treatment, no significant immune recovery occurred over a 2 y follow-up.