HIV-associated obstructive lung diseases: Insights and implications for the clinician

M. Bradley Drummond, Gregory D Kirk

Research output: Contribution to journalArticle

Abstract

The effectiveness of antiretroviral therapy to control HIV infection has led to the emergence of an older HIV population who are at risk of chronic diseases. Through a comprehensive search of major databases, this Review summarises information about the associations between chronic obstructive pulmonary disease (COPD), asthma, and HIV infection. Asthma and COPD are more prevalent in HIV-infected populations; 16-20% of individuals with HIV infection have asthma or COPD, and poorly controlled HIV infection worsens spirometric and diffusing capacity measurements, and accelerates lung function decline by about 55-75 mL/year. Up to 21% of HIV-infected individuals have obstructive ventilatory defects and reduced diffusing capacity is seen in more than 50% of HIV-infected populations. Specific pharmacotherapy considerations are needed to care for HIV-infected populations with asthma or COPD-protease inhibitor regimens to treat HIV (such as ritonavir) can result in systemic accumulation of inhaled corticosteroids and might increase pneumonia risk, exacerbating the toxicity of this therapy. Therefore, it is essential for clinicians to have a heightened awareness of the increased risk and manifestations of obstructive lung diseases in HIV-infected patients and specific therapeutic considerations to care for this population. Screening spirometry and tests of diffusing capacity might be beneficial in HIV-infected people with a history of smoking or respiratory symptoms.

Original languageEnglish (US)
Pages (from-to)583-592
Number of pages10
JournalThe Lancet Respiratory Medicine
Volume2
Issue number7
DOIs
StatePublished - 2014

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Obstructive Lung Diseases
HIV
Chronic Obstructive Pulmonary Disease
HIV Infections
Asthma
Population
Ritonavir
Spirometry
Protease Inhibitors
Pneumonia
Adrenal Cortex Hormones
Chronic Disease
Therapeutics
Smoking
Databases
Drug Therapy
Lung

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Medicine(all)

Cite this

HIV-associated obstructive lung diseases : Insights and implications for the clinician. / Drummond, M. Bradley; Kirk, Gregory D.

In: The Lancet Respiratory Medicine, Vol. 2, No. 7, 2014, p. 583-592.

Research output: Contribution to journalArticle

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