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Innovative HIV Case Study: Managing Lymphocytic Interstitial Pneumonia and Pulmonary Hypertension

This case presentation discusses a 48-year-old woman diagnosed with HIV in 1998. She presented with lymphocytic interstitial pneumonia and Sicca syndrome, showing CD4 count of 600 and elevated CD8 count of 4500. Examination revealed increased JVP and RV heave, leading to the diagnosis of infiltrative CD8 lymphocytic syndrome and HIV-related primary pulmonary hypertension. Treatment included AZT, 3TC, Ritonavir, and Lopinavir, resulting in significant improvement and normalized RVSP over 10 years. As of 2011, she maintains therapy with a CD4 count of 1100 and viral load <39.

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Innovative HIV Case Study: Managing Lymphocytic Interstitial Pneumonia and Pulmonary Hypertension

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  1. VIRTUAL MEDZONE Your Resource for HIV Related Innovative Medical Communication

  2. HIV CASE PRESENTATIONS Phil Sestak MD David Fletcher MD FRCPC

  3. CASE 1 • 48 yo woman • HIV+ 1998 • Presented with Lymphocytic interstitial pneumonia/Sicca syndrome • CD4 600 • CD8 4500

  4. CASE 1 O/E…Bp 120/80 CVS…increased JVP RV heave/Loud P2 2D Echo…Normal LV TR…RVSP 72mm/Hg Normal RV function RA size enlarged

  5. CASE 1 Diagnosis…Infiltrative CD8 Lymphocytic Syndrome and HIV related Primary Pulmonary Hypertension RX…AZT/3TC/Ritonavir/Lopinavir/Coumadin

  6. CASE 1 • Improved SOBOE over 6 months and dry mouth/eyes abated over 1 yr • Serial Echocardiograms done over 10 yrs reveal that RVSP has now normalized

  7. CASE 1 2011 Still going strong on AZT/3TC/Ritonavir/Lopinavir…unwilling to change nucleoside therapy • CD4 1100 CD8 1000 • Viral load<39

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