Despite anti-retroviral therapy (ART), human immunodeficiency virus-1 (HIV)-related pulmonary disease continues to be a major cause of morbidity and mortality for people living with HIV (PLWH). The spectrum of lung diseases has changed from acute opportunistic infections resulting in death to chronic lung diseases for those with access to ART. Chronic immune activation and suppression can result in impairment of innate immunity and progressive loss of T cell and B cell functionality with aberrant cytokine and chemokine responses systemically as well as in the lung. HIV can be detected in the lungs of PLWH and has profound effects on cellular immune functions. In addition, HIV-related lung injury and disease can occur secondary to a number of mechanisms including altered pulmonary and systemic inflammatory pathways, viral persistence in the lung, oxidative stress with additive effects of smoke exposure, microbial translocation, and alterations in the lung and gut microbiome. Although ART has had profound effects on systemic viral suppression in HIV, the impact of ART on lung immunology still needs to be fully elucidated. Understanding of the mechanisms by which HIV-related lung diseases continue to occur is critical to the development of new preventive and therapeutic strategies to improve lung health in PLWH.

中文翻译：

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HIV相关的肺部疾病的发病机制：免疫力，感染和炎症。

尽管有抗逆转录病毒疗法（ART），但与人类免疫缺陷病毒1（HIV）相关的肺部疾病仍然是HIV感染者（PLWH）发病和死亡的主要原因。肺部疾病的范围已从导致死亡的急性机会性感染变为对获得抗逆转录病毒疗法者的慢性肺部疾病。慢性免疫激活和抑制可导致先天性免疫功能受损，以及全身和肺部异常的细胞因子和趋化因子反应导致T细胞和B细胞功能的逐步丧失。可以在PLWH的肺部检测到HIV，并对细胞免疫功能产生深远影响。此外，与HIV相关的肺损伤和疾病可继发于多种机制，包括改变肺和全身炎症途径，肺部病毒持续存在，氧化应激与烟暴露，微生物易位以及肺和肠道微生物组的改变相加。尽管ART对HIV的全身性病毒抑制具有深远的影响，但是ART对肺免疫学的影响仍然需要充分阐明。了解与艾滋病相关的肺部疾病继续发生的机制对于开发新的预防和治疗策略以改善PLWH的肺部健康至关重要。