Chronic obstructive pulmonary disease in HIV
Katerina Byanova1, Ken M Kunisaki2,3, Joshua Vasquez1,4
1Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California San Francisco , San Francisco, CA, USA.
Expert Review of Respiratory Medicine
|November 10, 2020
Summary
People with HIV (PWH) have higher rates of chronic obstructive pulmonary disease (COPD). Understanding HIV
Area of Science:
- Pulmonary Medicine
- Infectious Diseases
- HIV/AIDS Research
Background:
- Chronic obstructive pulmonary disease (COPD) is more prevalent in people with HIV (PWH) than in the general population.
- COPD contributes to increased morbidity and mortality in PWH.
- Mechanisms of COPD development and progression in PWH are not fully understood, and PWH-specific management guidelines are lacking.
Purpose of the Study:
- To review the global epidemiology of COPD in PWH.
- To highlight pathways contributing to increased COPD prevalence and progression in PWH.
- To discuss lung structural/functional changes, excess mortality, comorbidities, and management in PWH with COPD.
Main Methods:
- This is a broad narrative review.
- Literature search on COPD in PWH, focusing on epidemiology, pathophysiology, clinical outcomes, and management.
Main Results:
- PWH exhibit higher COPD prevalence, contributing to significant morbidity and mortality.
- Proposed pathways involve HIV-specific factors, independent of smoking.
- Excess mortality and comorbidities are noted in PWH with COPD.
Conclusions:
- Understanding HIV's role in COPD development, independent of smoking, is crucial.
- Further research is needed on HIV-COPD pathophysiology, risk factors (opportunistic pneumonia, air pollution), and clinical trials for targeted therapies.
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