Background: The literature and anecdotal evidence associate the resolution of radiographic findings of lymphocytic interstitial pneumonitis (LIP) with a decline in immune and clinical status of human immunodeficiency virus (HIV) infected children.
Objective: As our clinical impression was the opposite, we sought to elucidate this contradiction.
Materials and methods: Of 52 pediatric patients infected with the HIV currently being followed at our institution, 20 (38.5%) carried the diagnosis of LIP and 13 (65%) of these have had complete resolution of radiographic findings of LIP. We retrospectively reviewed the chest radiographs, CD4 counts, and clinical history of these 13 patients.
Results: Of the 13 patients who had resolution of radiographic findings, 11 (84.6%) had no significant change in CD4 count at the time of resolution and remained clinically stable during a mean follow-up period of 32 months. Two patients (15.3%) developed severe CD4 lymphocytopenia at the time of resolution of LIP, but clinically remained stable. None of these 13 patients had a recurrence of LIP, even with subsequent increases in CD4 count.
Conclusion: We suggest that in contradiction to previously published data, resolution of LIP on chest radiographs is not an indicator for poor prognosis for the HIV-infected pediatric patient.