Impact of HIV infection and smoking on lung immunity and related disorders

Abstract

HIV-infected persons not only have higher rates of smoking than the general population, but are also unusually vulnerable to the associated adverse health effects, both infective and non-infective in origin. Indeed, in the setting of well-organised care and availability of HAART, HIV-infected smokers lose more life years to smoking than to HIV infection per se, presenting a major challenge to healthcare providers. Not surprisingly, the respiratory system is particularly susceptible to the damaging, interactive chronic inflammatory and immunosuppressive effects of HIV and smoking, intensifying the risk for development of opportunistic infections, as well as lung cancer and obstructive lung disorders. The impact of smoking on the immunopathogenesis and frequencies of these respiratory conditions in the setting of HIV infection, as well as on the efficacy of antiretroviral/antimicrobial therapy, represent the primary focus of the current review.