RESPIRATORY MORBIDITY FROM LYMPHOCYTIC INTERSTITIAL PNEUMONITIS (LIP)IN VERTICALLY ACQUIRED HIV-INFECTION

The aim of the study was to define the respiratory morbidity caused by lymphocytic interstitial pneumonitis (LIP) in children with verticall y acquired HIV infection. A retrospective case note review was perform ed on 95 children attending three London hospitals. Clinical and radio logical evidence of LIP, acute lower respiratory tract infections, and chronic lung disease was obtained using a structured protocol. A diag nosis of LIP had been made in 33%, and an acute admission due to acute lower respiratory tract infection had occurred in 42% of all children (despite 99% taking regular cotrimoxazole prophylaxis). Admission rat es because of acute lower respiratory tract infection were significant ly higher in the LIP group (0.38 admissions/child year) than in the no n-LIP group (0.17 admissions/child year) (p = 0.0002). Encapsulated ba cteria (Streptococcus pneumoniae, Haemophilus influenzae) were most fr equently isolated. Improved methods of prevention of acute lower respi ratory tract infection may help to reduce the severe respiratory morbi dity seen in children with LIP and HIV infection.