een seen in patients with AIDS. Pseudomonas aeruginosa pneumonia and sinusitis frequently occurs together in AIDS patients. In general, HIV infected patients are at increased risk for sinus infections, especially when theCD4+ cell count falls below 200/uL. In addition to the immunologic deficits associated with HIV infection, local factors may predispose the patient to sinus disease. Persistent bacterial colonization along with the loss of mucosal integrity from smoking or cocaine use may predispose a patient to recurrent bouts of sinusitis. In addition, prior sinusitis and impaired sinus drainage, possibly from lymphoid hyperplasia, may be risk factors for recurrent disease. How HAART will affect the incidence of pseudomonal infections is still not clear. A correlation between viral load and risk of opportunistic infections has been established, and there has been a decline in AIDS related morbidity and mortality in patients treated with aggressive anti-viral regimens. Most of the observed changes in immune competence relate to cellular immunity rather then humoral immunity. Thus, based on experiments, there is an anticipation of a decline in the incidence of sinopulmonary disease caused by Pseudomonas aeruginosa. Prospective studies are necessary to determine whether the patients with newly diagnosed HIV infection who have pulmonary damage will develop pseudomonal disease and to better define the changing epidemiology, optimal treatment strategies, and the role of adjunctive immunotherapies. Now that scientists have completed the genome sequence genetic map of Pseudomonas aeruginosa, it may lead to potential new treatments for patients with cystic fibrosis, patients with HIV, and others who develop this type of infection. This map of the genome provides scientists with a powerful tool that opens up new doors to develop innovative therapies that will make a difference in many lives. ...
