Drummond M Bradley, Kunisaki Ken M, Huang Laurence
Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Section of Pulmonary, Critical Care, and Sleep Medicine, Minneapolis VA Health Care System, Minneapolis, Minnesota.
Semin Respir Crit Care Med. 2016 Apr;37(2):277-88. doi: 10.1055/s-0036-1578801. Epub 2016 Mar 14.
HIV infection has shifted from what was once a disease directly impacting short-term mortality to what is now a chronic illness controllable in the era of effective combination antiretroviral therapy (ART). In this setting, life expectancy for HIV-infected individual is nearly comparable to that of individuals without HIV. Subsequent to this increase in life expectancy, there has been recognition of increased multimorbidity among HIV-infected persons, with prevalence of comorbid chronic illnesses now approaching 65%. Obstructive lung diseases, including chronic obstructive pulmonary disease (COPD) and asthma, are prevalent conditions associated with substantial morbidity and mortality in the United States. There is overlap in risk factors for HIV acquisition and chronic lung diseases, including lower socioeconomic status and the use of tobacco and illicit drugs. Objectives of this review are to (1) summarize the current state of knowledge regarding COPD and asthma among HIV-infected persons, (2) highlight implications for clinicians caring for patients with these combined comorbidities, and (3) identify key research initiatives to reduce the burden of obstructive lung diseases among HIV-infected persons.
HIV感染已从曾经直接影响短期死亡率的疾病转变为在有效联合抗逆转录病毒治疗（ART）时代可控制的慢性疾病。在这种情况下，HIV感染者的预期寿命几乎与未感染HIV的个体相当。随着预期寿命的增加，人们认识到HIV感染者的多种疾病发病率上升，合并慢性疾病的患病率目前接近65%。阻塞性肺病，包括慢性阻塞性肺疾病（COPD）和哮喘，是在美国与高发病率和死亡率相关的常见疾病。HIV感染和慢性肺病的危险因素存在重叠，包括社会经济地位较低以及使用烟草和非法药物。本综述的目的是：（1）总结关于HIV感染者中COPD和哮喘的当前知识状态；（2）强调对照顾这些合并症患者的临床医生的影响；（3）确定减轻HIV感染者阻塞性肺病负担的关键研究举措。
