Mechanisms Underlying HIV-Associated Noninfectious Lung Disease

Rachel M. Presti, Sonia C. Flores, Brent E. Palmer, Jeffrey J. Atkinson, Catherine R. Lesko, Bryan Lau, Andrew P. Fontenot, Jesse Roman, John F. McDyer, Homer L. Twigg

Research output: Contribution to journalReview articlepeer-review

21 Scopus citations


Pulmonary disease remains a primary source of morbidity and mortality in persons living with HIV (PLWH), although the advent of potent combination antiretroviral therapy has resulted in a shift from predominantly infectious to noninfectious pulmonary complications. PLWH are at high risk for COPD, pulmonary hypertension, and lung cancer even in the era of combination antiretroviral therapy. The underlying mechanisms of this are incompletely understood, but recent research in both human and animal models suggests that oxidative stress, expression of matrix metalloproteinases, and genetic instability may result in lung damage, which predisposes PLWH to these conditions. Some of the factors that drive these processes include tobacco and other substance use, direct HIV infection and expression of specific HIV proteins, inflammation, and shifts in the microbiome toward pathogenic and opportunistic organisms. Further studies are needed to understand the relative importance of these factors to the development of lung disease in PLWH.

Original languageEnglish
Pages (from-to)1053-1060
Number of pages8
Issue number5
StatePublished - Nov 2017


  • COPD
  • HIV
  • inflammation
  • lung cancer
  • pulmonary hypertension


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