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HIV infection and lung function decline: challenges, clinical implications, and new questions

机译：HIV感染和肺功能下降：挑战，临床意义和新问题

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Pulmonary diseases, especially pneumonia, have been among the most frequent complications of HIV since early in the AIDS epidemic. In parallel with other complications of HIV, the spectrum of pulmonary diseases currently reflects a substantial burden of non-AIDS-defming chronic diseases as HIV-infected patients are aging on antiretroviral therapy (ART). A leading cause of global mortality, chronic obstructive pulmonary disease (COPD) is the most common chronic lung disease diagnosed in HIV-infected patients, encountered in approximately 20% of patients in different cohorts. However, our understanding of the impact of chronic HIV infection on lung health over time remains incomplete. Does HIV cause a unique impairment in lung health, or is HIVa 'second hit' to accelerate the toxic effects of other exposures such as cigarette smoking to cause typical diseases like COPD? Or, is the increased burden of lung diseases in HIV merely explained by a greater prevalence of smoking, drug use, respiratory infections, and other exposures that are common in many HIV-infected populations?
机译：自从艾滋病流行初期以来，肺部疾病，特别是肺炎，一直是艾滋病毒最常见的并发症之一。与HIV的其他并发症同时出现的同时，由于抗HIV感染的患者正在接受抗逆转录病毒疗法（ART）的老化，肺部疾病谱目前反映出非艾滋病定义的慢性疾病的沉重负担。慢性阻塞性肺疾病（COPD）是全球死亡率的主要原因，是在HIV感染患者中诊断出的最常见的慢性肺疾病，在不同队列的患者中约有20％遇到。但是，随着时间的流逝，我们对慢性HIV感染对肺部健康的影响的了解仍然不完整。 HIV是对肺部健康造成独特的损害，还是“第二次打击” HIVa来加速其他暴露（如吸烟）的毒性作用，从而导致典型疾病（如COPD）？还是仅通过吸烟，吸毒，呼吸道感染和许多在HIV感染人群中普遍存在的其他暴露水平更高的原因来解释HIV中肺部疾病负担的增加？

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