Infecciones pulmonares en pacientes con VIH 20 años después de la terapia antirretroviral combinada. ¿qué ha cambiado?

Background Prior to 1996, HIV was considered practically fatal. However, after highly active antiretroviral therapy was introduced, HIV became a chronic disease with a great increase in life expectancy. Despite this therapy, there are many complications to which an HIV infected person is exposed, with the lung the most commonly affected organ. Opportunistic infections such as pneumocystis pneumonia, histoplasmosis, tuberculosis, nontuberculous mycobacteria, among others, are still important threats to the HIV population. Objective This review aims to address changes in the diagnosis, prognosis and epidemiology of HIV-infected patients with lung infections since the introduction of highly active antiretroviral therapy was introduced. Methodology The electronic databases MEDLINE (PubMed), EMBASE, LILACS and SciELO were reviewed. Systematic reviews, randomised, controlled studies, case series, «before and after», observational studies from 1995 until December 2014 were included in addition to epidemiological data from the WHO. Conclusions After nearly 20 years since its introduction, combined antiretroviral therapy has changed the natural history of HIV infection, with a decrease in the frequency of occurrence and mortality related to most pathogens involving the respiratory tract.