BACTERIAL PNEUMONIA IN ADULT-POPULATIONS WITH HUMAN-IMMUNODEFICIENCY-VIRUS (HIV) INFECTION

Recurrent bacterial pneumonia was recently added to the definition of the acquired immunodeficiency syndrome (AIDS), based on the observatio n that bacterial pneumonia rates have been increased in human immunode ficiency virus (HIV)-infected persons and are indicative of immunosupp ression in this population. Nonetheless, risk factors for bacterial pn eumonia among HIV-infected persons remain largely uninvestigated. Iden tification of risk factors that may be associated with bacterial pneum onia can guide development of future interventions and further clarify target groups for such interventions. From a methodological viewpoint , diagnostic algorithms need to be further standardized to provide com parable estimates of disease incidence. Epidemiologic studies will als o need to address the effectiveness of chemoprophylaxis and vaccine in terventions in HIV-infected populations. Since clinical trials will no t be feasible for testing efficacy of interventions that are already r ecommended, observational data will be critically important in guiding clinical practice.