| The potential spectrum
of pulmonary disease in an HIV-infected patient presenting
with fever, cough, and dyspnea is very broad, and there are
many advantages to establishing a specific diagnosis for each
episode. The likely causative agent is dependent on many factors,
including the clinical presentation, the patient's immune
status, environmental exposures (recent and long prior), and
recent medication experience.
CD4 counts remain a highly useful parameter for assessing
the risk of opportunistic infection in patients with HIV
infection. Even in the era of CD4 augmentation by highly
active antiretroviral therapy, these counts appear to be
reliable indicators of the risk of opportunistic infection.
Other factors, such as HIV viral load, unexplained fever
or oropharyngeal thrush are also independent predictors
of opportunistic infections or tumors in general.
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