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

Int J Chron Obstruct Pulmon Dis. 2023 Nov 29:18:2795-2817. doi: 10.2147/COPD.S388142. eCollection 2023.

Abstract

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: COPD; HIV; air pollution; immune activation; pulmonary infections; smoking; tuberculosis.

Publication types

  • Review

MeSH terms

  • HIV Infections* / diagnosis
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • Humans
  • Inflammation / complications
  • Lung
  • Pulmonary Disease, Chronic Obstructive* / diagnosis
  • Pulmonary Disease, Chronic Obstructive* / epidemiology
  • Pulmonary Disease, Chronic Obstructive* / prevention & control
  • Risk Factors