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Obstructive Lung Disease in HIV-Phenotypes and Pathogenesis.

Deepti Singhvi¹, Jessica Bon^2,3, Alison Morris²

¹Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. singhvidg@upmc.edu.

Current HIV/AIDS Reports

|July 1, 2019

Summary

People living with HIV (PLWH) are experiencing more chronic illnesses like chronic obstructive pulmonary disease (COPD). HIV is linked to specific COPD phenotypes, influenced by factors like the lung microbiome and residual HIV.

Keywords:

Chronic obstructive Emphysema HIV Pathogenesis Phenotypes Pulmonary

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Area of Science:

Pulmonology
Infectious Diseases
HIV Medicine

Background:

Antiretroviral therapy has increased longevity for people living with HIV (PLWH).
Chronic illnesses, including chronic obstructive pulmonary disease (COPD), are more common in aging PLWH.
COPD presents with diverse phenotypes, not as a single entity.

Purpose of the Study:

To review the impact of HIV on COPD phenotypes.
To explore the distinct pathogenetic mechanisms of HIV-associated COPD phenotypes.
To understand how these phenotypes affect therapeutic responses.

Main Methods:

Review of current literature on HIV and COPD.
Analysis of factors influencing COPD pathogenesis in PLWH.
Examination of the role of HIV-specific elements and lung microbiome.

Main Results:

HIV is an independent risk factor for specific COPD phenotypes.
Impaired diffusing capacity, airflow obstruction, and emphysema are observed in PLWH, correlating with mortality.
Age, sex, tobacco use, altered lung microbiome, and residual HIV modulate COPD severity and phenotypes.

Conclusions:

COPD is prevalent in PLWH, with multiple phenotypes contributing to disease burden.
HIV-specific factors and the respiratory microbiome play roles in COPD pathogenesis.
Smoking cessation is crucial for all PLWH due to tobacco's significant contribution to COPD risk.