Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California San Francisco , San Francisco, CA, USA.
Section of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Minneapolis Veterans Affairs Health Care System , Minneapolis, MN, USA.
Expert Rev Respir Med. 2021 Jan;15(1):71-87. doi: 10.1080/17476348.2021.1848556. Epub 2020 Nov 23.
: Chronic obstructive pulmonary disease (COPD) is more prevalent in people with HIV (PWH) than in the general population and leads to an increased burden of morbidity and mortality in this population. The mechanisms behind COPD development and progression in PWH are not fully elucidated, and there are no PWH-specific guidelines for COPD management. : The goal of this broad narrative review is to review the epidemiology of COPD in PWH globally, highlight proposed pathways contributing to increased COPD prevalence and progression in PWH, discuss structural and functional changes in the lungs in this population, assesses the excess mortality and comorbidities in PWH with COPD, and address management practices for this unique population. : Understanding how a chronic viral infection leads to COPD, independent of cigarette smoking, is of critical scientific importance. Further research should focus on the pathophysiology of the interaction between HIV and COPD, and determine the role of disease-modifying risk factors such as opportunistic pneumonia and air pollution, as well as generate data from randomized clinical trials on the safety and efficacy of specific therapies for this vulnerable patient population.
: 慢性阻塞性肺疾病（COPD）在艾滋病毒（HIV）感染者（PWH）中比一般人群更为普遍，导致该人群的发病率和死亡率负担增加。PWH 中 COPD 发展和进展的背后机制尚未完全阐明，也没有针对 COPD 管理的 PWH 特异性指南。: 本广泛叙述性综述的目的是回顾全球 PWH 中 COPD 的流行病学，强调导致 PWH 中 COPD 患病率和进展增加的潜在途径，讨论该人群中肺部的结构和功能变化，评估 COPD 合并 HIV 的患者的超额死亡率和合并症，并解决针对这一特殊人群的管理实践。: 了解慢性病毒感染如何导致 COPD，而与吸烟无关，这具有重要的科学意义。进一步的研究应集中在 HIV 和 COPD 相互作用的病理生理学上，并确定改变疾病的风险因素（如机会性肺炎和空气污染）的作用，以及针对这一脆弱患者群体的特定治疗方法的安全性和疗效的随机临床试验数据。
