Abstract :
Acute Chest Syndrome (ACS) is a leading cause of morbidity and mortality in patients with sickle cell disease (SCD),
and its management becomes more complex in individuals living with both HIV and SCD. The dual challenges of
HIV-related immune suppression and sickle cell-induced pulmonary complications exacerbate the severity and
prognosis of ACS in this population. This review aims to explore the pathophysiology, clinical manifestations,
diagnostic approaches, and management strategies for ACS in HIV-positive SCD patients, highlighting the need for a
comprehensive and individualized care plan. Given the increased risk of infections, hypoxia, and vasculopathy in
these patients, a multifaceted therapeutic approach is essential for improving outcomes. The pathophysiology of ACS
in HIV-positive SCD patients involves both sickle cell-related microvascular obstruction and immune suppression
caused by HIV. Infections, such as pneumonia or tuberculosis, are common triggers for ACS in this population,
further complicating the clinical picture. The combined effects of these conditions lead to increased inflammation,
endothelial dysfunction, and pulmonary impairment, all of which contribute to the progression of ACS. Diagnostic
approaches include imaging studies, such as chest X-ray and CT scans, along with microbiological investigations to
identify infections that may precipitate ACS episodes.
Keyword :
Acute Chest Syndrome, HIV, Sickle Cell Disease, Pain Management, Respiratory Support