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Review
. 2011 Jun;8(3):320-5.
doi: 10.1513/pats.201006-045WR.

HIV and chronic obstructive pulmonary disease: is it worse and why?

Alison Morris  1 , M Patricia George, Kristina Crothers, Laurence Huang, Lorrie Lucht, Cathy Kessinger, Eric C Kleerup; Lung HIV Study
Affiliations
Review

HIV and chronic obstructive pulmonary disease: is it worse and why?

Alison Morris et al. Proc Am Thorac Soc. 2011 Jun.

Abstract

Smoking-related diseases, such as chronic obstructive pulmonary disease (COPD), are of particular concern in the HIV-infected population. Smoking rates are high in this population, and long-term exposure to cigarette smoke in the setting of HIV infection may increase the number of complications seen. Before the era of combination antiretroviral therapy, HIV-infected persons were noted to have an accelerated form of COPD, with significant emphysematous disease seen in individuals less than 40 years old. Unlike many of the AIDS-defining opportunistic infections, HIV-associated COPD may be more common in the current era of HIV because it is frequently reported in patients without a history of AIDS-related pulmonary complications and because many aging HIV-infected individuals have had a longer exposure to smoking and HIV. In this review, we document the epidemiology of HIV-associated COPD before and after the institution of combination antiretroviral therapy, review data suggesting that COPD is accelerated in those with HIV, and discuss possible mechanisms of HIV-associated COPD, including an increased susceptibility to chronic, latent infections; an aberrant inflammatory response; altered oxidant-antioxidant balance; increased apoptosis associated with HIV; and the effects of antiretroviral therapy.

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Figures

Figure 1.
Figure 1.
Chest CT of a 44-year-old woman with HIV. She was receiving antiretroviral therapy, and her CD4+ cell count was 479 cells/μl. Note the diffuse emphysematous changes with multiple areas of bullous lung disease. Reproduced with permission from A. Morris.
Figure 2.
Figure 2.
Potential mechanisms of antiretroviral-mediated lung damage in HIV.
See this image and copyright information in PMC

References

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