Florica Stăniceanu *, Sabina Zurac **, Adrian Streinu-Cercel ***
* Conf. dr. Florica Stăniceanu, UMF “Carol Davila”, șef Laboratornl de Anatomie Patologică, Spitalul Clinic Colentina, București
** Dr. Sabina Zurac, Laboratorul de Anatomie Patologică, Spitalul Clinic Colentina, București
*** Dr. Adrian Streinu-Cercel, șef lucrări UMF “Carol Davila”, medic primar șef secție Institutul de Boli lnfecțioase “Prof. dr. Matei Balș”, București
Abstract
Pneumocystosis is the disease produced by a saprophyte protozoan, Pneumocystis carinii; it appears in patients with cellular immune dysfunctions. Before highly active antiretroviral therapy (HAART) and primary anti-Pneumocystis carinii prophylaxis, the Pneumocystis carinii pneumonia (PCP) represented the most frequent opportunistic infection in AIDS patients (about 80-90%); nowadays it appears in 27% of the HIV infectid patients. HMRT improved also the circumstances the opportunity of the prophylaxis of the Pneumocystis carinii infection being on debate.In HIV positive adults, PCP is one of the most frequent causes of the pulmonary diseases. The defense mechanism against Pneumocystis carinii implies in the beginning the intervention of the alveolar macrophages and type I pneumocytes, the phagocytosis depending on the mannose receptors from the macrophage cell surfac_e and the intracellular destruction relying on oxidative processes. The Pneumocystis carinii infection is manifesting as interstitial pneumaonia, rarely as cavitary lesions; immunorestitution manifestations may appear in HIV positive patients with subclinical pneumocystosis after HMRT when a significant rising of level of the CD4+ T lymfocytes occurs. The prognosis is unfavorable, the most important risk factor being the level of CD4+ T lymphocytes (less than 50 cells/mm3).