Lung function abnormalities in HIV‐infected adults and children

Abstract

Despite the advent of antiretroviral therapy (ART), the human immunodeficiency virus (HIV) epidemic remains a global health crisis with a high burden of respiratory disease among infected persons. While the early complications of the epidemic were dominated by opportunistic infections, improved survival has led to the emergence of non-infectious conditions that are associated with chronic respiratory symptoms and pulmonary disability. Obstructive ventilatory defects and reduced diffusing capacity are common findings in adults, and the association between HIV and chronic obstructive pulmonary disease is increasingly recognized. There is synergism between viral factors, opportunistic infections, conventional influences like tobacco smoke and biomass fuel exposure, and potentially, the immunological effects of ART on the development of HIV-associated chronic obstructive lung disease. Pulmonary function data for HIV-infected infants and children are scarce, but shows that bronchiectasis and obliterative bronchiolitis with severe airflow limitation are major problems, particularly in the developing world. However, studies from these regions are sorely lacking. There is thus a major unmet need to understand the influences of chronic HIV

High‐resolution computed tomography features of lung disease in perinatally HIV‐infected adolescents on combined antiretroviral therapy

“…Our study, however, demonstrated no correlation between the duration, age at commencing treatment or regimen of cART with BO. This is consistent with later longitudinal studies demonstrating a protective effect of cART on lung health, with less lung function deterioration in adults . In addition, HIV has been shown to be an independent risk factor for the development of emphysema, in adults with poor virological control .…”

“…This is consistent with later longitudinal studies demonstrating a protective effect of cART on lung health, with less lung function deterioration in adults. 16,24,25 In addition, HIV has been shown to be an independent risk factor for the development of emphysema, in adults with poor virological control. 26 Two of our were the second most prevalent finding, the extent in all, but a single patient with suspected miliary TB, was minimal.…”

Follicular bronchiolitis in an HIV-infected individual on combination antiretroviral therapy with low CD4+ cell count but sustained viral suppression

“…As such, NSIP and possibly also FB might mimic PCP in patients with HIV. Although the potential immune reconstitution syndrome following initiation of cART could potentially mimic the case,1 the patient described in the case had been on cART since September 2013. Unfortunately, we are unable to provide any explanation for the underlying mechanism of FB under the condition of low CD4+ count and low VL.…”

“…The epidemiology of pulmonary diseases in HIV-infected individuals has changed since the advent of combination antiretroviral therapy (cART) in the mid-1990s 1. Although classic HIV-related pulmonary diseases such as Pneumocystis pneumonia (PCP), tuberculosis, Kaposi’s sarcoma and recurrent pneumococcal pneumonia remain rather common, smoking-related lung diseases has by far become the most important pulmonary diseases in HIV-infected people living in Western Europe and North America 2–5.…”

Oxygen Levels Affect Macrophage HIV-1 Gene Expression and Delay Resolution of Inflammation in HIV-Tg Mice

“…Combination antiretroviral therapy (cART) significantly improved the longevity of people living with HIV-1 (PLWH), improving immune function and decreasing opportunistic infections. However, chronic long-term HIV-1 infection is complicated by the increased rates of chronic medical conditions in aging population, including cardiovascular and neurological diseases, metabolic syndrome, and non-infectious respiratory disease, which summarily contribute to HIV-1 morbidity and mortality [1,2]. About 30% of PLWH are positive for three or more concurrent comorbidities [3].…”