Quintero David, Guidot David M
Atlanta VA Medical Center and Emory University School of Medicine, Atlanta, Georgia.
Alcohol Res Health. 2010;33(3):219-28.
Both HIV-1 infection and chronic alcohol abuse adversely affect lung health. For example, through multiple mechanisms, chronic alcohol abuse increases one's susceptibility to pneumonia, particularly pneumonia caused by certain serious pathogens. Similarly, pneumonia caused by opportunistic pathogens is very common in HIV-infected patients, at least in part because HIV-1 attacks the immune cells of the lungs and interferes with their functions. Alcohol abuse also increases the risk of developing acute respiratory distress syndrome, a serious acute lung condition; however, the association of this syndrome with HIV-1 infection remains unclear. Chronic lung conditions potentially caused or exacerbated by chronic alcohol abuse include asthma, emphysema, or chronic bronchitis, although the findings to date are equivocal. However, growing evidence indicates that HIV-1 infection increases the risk of chronic pulmonary diseases such as emphysema, lung cancer, and excessive blood pressure in the vessels supplying the lung (i.e., pulmonary hypertension). Both alcohol abuse and HIV infection can impair lung function through various mechanisms, including increasing oxidative stress and enhancing antioxidant deficits, preventing full activation of the lung's immune cells, and contributing to zinc deficiency. However, the interactions between alcohol abuse and HIV-1 infection in contributing to the range of lung disorders have not been studied in detail.
HIV-1感染和慢性酒精滥用均会对肺部健康产生不利影响。例如,慢性酒精滥用通过多种机制增加了患肺炎的易感性,尤其是由某些严重病原体引起的肺炎。同样,机会性病原体引起的肺炎在HIV感染患者中非常常见,至少部分原因是HIV-1攻击肺部免疫细胞并干扰其功能。酒精滥用还会增加患急性呼吸窘迫综合征(一种严重的急性肺部疾病)的风险;然而,该综合征与HIV-1感染之间的关联仍不明确。慢性酒精滥用可能导致或加重的慢性肺部疾病包括哮喘、肺气肿或慢性支气管炎,尽管迄今为止的研究结果并不明确。然而,越来越多的证据表明,HIV-1感染会增加患慢性肺部疾病的风险,如肺气肿、肺癌以及肺部供血血管的血压过高(即肺动脉高压)。酒精滥用和HIV感染均可通过多种机制损害肺功能,包括增加氧化应激和加剧抗氧化剂缺乏、阻止肺部免疫细胞充分激活以及导致锌缺乏。然而,酒精滥用与HIV-1感染在导致一系列肺部疾病方面的相互作用尚未得到详细研究。