COPD in People with HIV: Epidemiology, Pathogenesis, Management, and Prevention Strategies

Abstract

Katerina L Byanova,1,* Rebecca Abelman,2,* Crystal M North,3 Stephanie A Christenson,1 Laurence Huang1,2 1Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA; 2Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA; 3Division of Pulmonary and Critical Care Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA*These authors contributed equally to this workCorrespondence: Laurence Huang, HIV, Infectious Diseases, and Global Medicine Division, Room 2807, UCSF Pride Hall, 2540 23rd Street, San Francisco, CA, 94110, USA, Tel [phone], Extension 406, Fax [phone], Email [email protected]: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder characterized by airflow limitation and persistent respiratory symptoms. People with HIV (PWH) are particularly vulnerable to COPD development; PWH have demonstrated both higher rates of COPD and an earlier and more rapid decline in lung function than their seronegative counterparts, even after accounting for differences in cigarette smoking. Factors contributing to this HIV-associated difference include chronic immune activation and inflammation, accelerated aging, a predilection for pulmonary infections, alterations in the lung microbiome, and the interplay between HIV and inhalational toxins. In this review, we discuss what is known about the epidemiology and pathobiology of COPD among PWH and outline screening, diagnostic, prevention, and treatment strategies.Keywords: HIV, COPD, tuberculosis, air pollution, immune activation, smoking, pulmonary infections

Keywords

• hiv
• copd
• tuberculosis
• air pollution
• immune activation
• smoking
• pulmonary infections