This narrative review discusses literature on chronic obstructive pulmonary disease (COPD) in people living with HIV (PLWH). Existing data indicate that HIV itself, independent of smoking, constitutes a pathogenic agent implicated in this disease condition. COPD can be viewed not exclusively as a pulmonary disease but rather as a systemic syndrome sparked and fueled by a persistent low-grade HIV-attributable inflammatory state. We speculate that even in the absence of airflow obstruction on spirometry, HIV-related lung disease can manifest with respiratory symptoms and structural lung derangement. Although not fully satisfying the global initiative for obstructive lung disease criteria for COPD, this phenotype of small airways lung disease is related to significant impairment of lung health and is associated with a high comorbidity burden. Within the specific context of the aging epidemic affecting HIV patients characterized by a high burden of comorbidities, frailty, and disabilities HIV-related lung disease has to be fit into the framework of the general comorbidity burden that PLWH experience, due to both HIV infection and to incidental HIV-unrelated risk factors. In this review, we will also provide a list of research gaps and an agenda for future studies in HIV patients.

中文翻译：

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HIV患者的慢性肺疾病

这篇叙述性评论讨论了有关艾滋病毒感染者（PLWH）的慢性阻塞性肺疾病（COPD）的文献。现有数据表明，HIV本身独立于吸烟，是与这种疾病有关的致病因子。COPD不仅可以视为肺部疾病，还可以看作是由持续的低度归因于HIV的炎症状态引发并助长的系统性综合症。我们推测，即使在肺活量测定中没有气流阻塞，与HIV相关的肺部疾病也会表现为呼吸道症状和结构性肺部紊乱。尽管不能完全满足COPD阻塞性肺疾病标准的全球倡议，但这种小气道肺部疾病的表型与肺部健康严重受损有关，并伴有高合并症负担。在以合并症，虚弱症和残疾负担高为特征的影响艾滋病毒患者的流行病的特定背景下，艾滋病毒相关的肺部疾病必须纳入艾滋病毒感染和感染的艾滋病毒/艾滋病患者所面临的一般合并症负担的框架内。艾滋病相关的偶然危险因素。在这篇评论中，我们还将提供研究空白列表和未来艾滋病患者研究的议程。