HIV infection and lung function decline: challenges, clinical implications, and new questions.
HIV infection and lung function decline: challenges, clinical implications, and new questions.
复制标题
HIV 感染和肺功能下降：挑战、临床影响和新问题。
DOI：
10.1097/qad.0b013e3283601082
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Morris,Alison
中科院分区：
文献类型：
--
作者：
Crothers,Kristina;Morris,Alison
Pulmonary diseases, especially pneumonia, have been among the most frequent complications of HIV since early in the AIDS epidemic [1–3]. In parallel with other complications of HIV, the spectrum of pulmonary diseases currently reflects a substantial burden of non-AIDS-defining chronic diseases as HIV-infected patients are aging on antiretroviral therapy (ART)[4–9]. A leading cause of global mortality [10, 11], chronic obstructive pulmonary disease (COPD) is the most common chronic lung disease diagnosed in HIV-infected patients, encountered in approximately 20% of patients in different cohorts [4, 6, 8, 9, 12]. However, our understanding of the impact of chronic HIV infection on lung health over time remains incomplete. Does HIV cause a unique impairment in lung health, or is HIV a ‘second hit’to accelerate the toxic effects of other exposures such as cigarette smoking to cause typical diseases like COPD? Or, is the increased burden of lung diseases in HIV merely explained by a greater prevalence of smoking, drug use, respiratory infections, and other exposures that are common in many HIV-infected populations?To date, whether HIV infection is an independent risk factor for chronic lung diseases, particularly COPD, remains uncertain. Cross-sectional studies in HIV-infected and uninfected persons comparing the prevalence of COPD, defined by the presence of fixed airflow obstruction on spirometry, have had somewhat conflicting results [6, 8]. Disentangling the effects of numerous behavioral, environmental, and occupational exposures, and the contribution of comorbid conditions from those of HIV infection on lung health is challenging, particularly in cross-sectional analyses.
