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.