How is Pneumocystis pulmonary infection in HIV-pt?

Incidence is declining with ART (antiretroviral therapy) and prophylaxis. but it is one of the leading causes of infections in HIV with low CD4, recognized as a fungus, used to be a protozoan, but they are atypical fungi (don't grow in cultures, cell wall with cholesterol) Airbourne transmission, primary infection occurs by age of 4 usually, remains latent until immunosupressed, exists in alveoli exclusively, attach epithelium and macrophages