Immunological and microbiological features of chronic obstructive pulmonary disease in HIV-infected patients

Relevance. Chronic obstructive pulmonary disease represents a significant public health problem, particularly in patients with human immunodeficiency virus (HIV), where it is more severe and more common.
Objective. To systematize and summarize literature data on the immunological and microbiological factors underlying the development and progression of chronic obstructive pulmonary disease in this patient population.
Materials and Methods. A systematic review of articles in leading databases from 2000 to 2024, as well as original studies, reviews, and meta-analyses, was conducted.
Results. Chronic systemic inflammation, immune dysfunction, and pulmonary microbiota dysbiosis were found to play a key role in the pathogenesis. Specific factors, such as low CD4 lymphocyte counts and recurrent respiratory infections, accelerate lung tissue damage.
Conclusions. The concurrence of human immunodeficiency virus infection and chronic obstructive pulmonary disease is a complex pathological process that leads to rapid disease progression. Understanding the relevant mechanisms is critical for developing targeted prevention and treatment strategies.

1. Ministerstvo zdravookhraneniya Rossiiskoi Federatsii. Klinicheskie rekomendatsii «Khronicheskaya obstruktivnaya bolezn' legkikh». Moscow; 2024. (In Russ.). (DOI not applicable).

2. Global HIV & AIDS statistics — Fact sheet. UNAIDS; 2024. Available at: https://www.unaids.org/en/resources/fact-sheet. Проверено: 27.08.2025.

3. Deeks S.G. Immune dysfunction, inflammation, and accelerated aging in patients on antiretroviral therapy. Top HIV Med. 2009;17(4):118-123. https://doi.org/10.46249/thivm.17.4.118

4. Bigna J.J., Kenne A.M., Asangbeh S.L. Prevalence of chronic obstructive pulmonary disease in the global population with HIV: a systematic review and meta-analysis. Lancet Glob. Health. 2022;6(2):e193-e202. https://doi.org/10.1016/S2214-109X(17)30451-5

5. Fitzpatrick M.E., Kunisaki K.M., Morris A. Pulmonary disease in HIV-infected adults in the era of antiretroviral therapy. AIDS. 2018;32(3):277-292. https://doi.org/10.1097/QAD.0000000000001712

6. Diaz P.T., King M.A., Pacht E.R., et al. Increased susceptibility to pulmonary emphysema among HIV-seropositive smokers. Ann Intern Med. 2000;132(5):369-372. https://doi.org/10.7326/0003-4819-132-5-200003070-00006

7. Kuhlman J.E., Knowles M.C., Fishman E.K., Siegelman S.S. Premature bullous pulmonary damage in AIDS: CT diagnosis. Radiology. 1989;173(1):23-26. https://doi.org/10.1148/radiology.173.1.2675177

8. Petrache I., Diab K., Knox K.S., et al. HIV-associated pulmonary emphysema: a review of the literature and inquiry into its mechanism. Thorax. 2008;63(5):463-469. https://doi.org/10.1136/thx.2007.079111

9. Lalloo U.G., Pillay S., Mngqibisa R., Abdool-Gaffar S., Ambaram A. HIV and COPD: a conspiracy of risk factors. Respirology. 2016;21(7):1166-1172. https://doi.org/10.1111/resp.12806

10. Lalloo U.G., Pillay S., Mngqibisa R., Abdool-Gaffar S., Ambaram A. HIV and COPD: a conspiracy of risk factors. Respirology. 2016;21(7):1166-1172. https://doi.org/10.1111/resp.12806

11. Fanales-Belasio E., Raimondo M., Suligoi B., Buttò S. HIV virology and pathogenetic mechanisms of infection: a brief overview. Ann Ist Super Sanita. 2010;46(1):5-14. https://doi.org/10.4415/ANN_10_01_02

12. Gurgo C., Robert-Guroff M., Gallo R.C. An overview of the human Tlymphotropic retroviruses and the role of HTLV-III/LAV in AIDS. Antibiot Chemother. 1987;38:1-12. https://doi.org/10.1159/000414214

13. Pokrovskii V.V. Lektsii po VICH-infektsii. Pod red. V.V. Pokrovskogo. 2nd ed., rev. and add. M.: GEOTAR-Media; 2018. (In Russ.).

14. Shakhgil'dian V.I., Iadrikhinskaia M.S., Safonova A.P., et al. Struktura vtorichnykh zabolevanii i sovremennye pokhody k ikh laboratornoi diagnostike u bol'nykh VICH-infektsiei. Epidemiologiia i Infektsionnye Bolezni=Epidemiology and Infectious Diseases. 2015;(1):24-30. (In Russ.). https://www.google.com/search?q=https://doi.org/10.17816/eid12740

15. Singhvi D., Bon J., Morris A. Obstructive Lung Disease in HIV-Phenotypes and Pathogenesis. Curr. HIV/AIDS Rep. 2019;16(4):359-369. https://doi.org/10.1007/s11904-019-00456-3

16. Raynaud C., Roche N., Chouaid C. Interactions between HIV infection and chronic obstructive pulmonary disease: Clinical and epidemiological aspects. Respir Res. 2011;12(1):117. https://doi.org/10.1186/1465-9921-12-117

17. Maitre T., Cottenet J., Beltramo G., et al. Increasing burden of noninfectious lung disease in persons living with HIV: a 7-year study using the French nationwide hospital administrative database. Eur Respir J. 2018;52(3):1800359. https://doi.org/10.1183/13993003.00359-2018

18. Viktorova I.B., Zimina V.N., Kravchenko A.V. Khronicheskaya obstruktivnaya bolezn' legkikh pri VICH infektsii. VICH-Infektsiya i Immunosupressii=HIV Infection and Immunosuppressive Disorders. 2020;12(2):7-17. (In Russ.). https://doi.org/10.22328/2077-9828-2020-12-2-7-17

19. Guaraldi G., Besutti G., Scaglioni R., et al. The Burden of Image Based Emphysema and Bronchiolitis in HIV-Infected Individuals on Antiretroviral Therapy. PLoS One. 2014;9(9):e107027. https://doi.org/10.1371/journal.pone.0107027

20. Salokhiddinov Z.S., Kodirov D.A. Sravnitel'nyi analiz rasprostranennosti lipidnykh i nelipidnykh biokhimicheskikh faktorov riska khronicheskikh obstruktivnykh zabolevanii legkikh sredi VICH-infitsirovannoi populiatsii. Biulleten' Assotsiatsii Vrachei Uzbekistana=Bulletin of the Association of Doctors of Uzbekistan. 2021;4(105):68-70. (In Russ.). https://doi.org/10.38069/1400-0110-2021-4-105-68-70

21. Fedotov V.D., Zhestkov A.V., Lyamin A.V., et al. Osobennosti mikrobioty u patsientov s razlichnymi klinicheskimi fenotipami KhOBL professional'noi etiologii. Klinicheskaia Mikrobiologiia i Antimikrobnaia Khimioterapiia=Clinical Microbiology and Antimicrobial Chemotherapy. 2025;27(1):111-120. (In Russ.). https://doi.org/10.36488/cmac.2025.1.111-120

22. Makarova E.V. Clinical and functional, immunological, microbiological features of the course and possibilities of therapy for chronic obstructive pulmonary disease: abstract of dis. ... Doctor of Medical Sciences. Nizhny Novgorod; 2017;48. (In Russ.)

23. Lavrenyuk V.V., Beniova S.N., Simakova A.I., et al. VICH-assotsiirovannye pnevmonii: bakterial'nye, gribkovye, virusnye. Tikhookeanskii Meditsinskii Zhurnal=Pacific Medical Journal. 2024;(1):29-34. (In Russ.). https://doi.org/10.34215/1609-1175-2024-1-29-34

24. Ermak T.N. Opportunisticheskie (vtorichnye) zabolevaniia u bol’nykh VICH–infektsiei v Rossiiskoi Federatsii: struktura, klinicheskaia diagnostika, lechenie. Chast’ 1. Tuberkulez i pnevmotsistnaia pnevmoniia. Farmateka=Pharmateca. 2010;4:52-56. (In Russ.). https://doi.org/10.18565/pharmateca.2010.4.52.56

25. Zimina V.N., Kravchenko A.V., Viktorova I.B., Koshechkin V.A. Tuberkulez i VICH-infektsiia u vzroslykh. 2nd ed., rev. and add. M.: GEOTAR-Media; 2020;256. (In Russ.).

26. Panteleev A.M. Tuberkulez organov dykhaniia u bol'nykh s VICH-infektsiei. VICH-Infektsiia i Immunosupressii=HIV Infection and Immunosuppressive Disorders. 2010;2(1):16-22. (In Russ.). https://doi.org/10.22328/2077-9828-2010-2-1-16-22

27. Zimina V.N., Kravchenko A.V., Viktorova I.B., Koshechkin V.A. Tuberkulez i VICH-infektsiia u vzroslykh. 2nd ed., rev. and add. M.: GEOTAR-Media; 2020;256. (In Russ.).

28. Khadi T., Shchelykalina S. P., Anaev E. Kh. Endoscopic features of respiratory tract lesions in chronic obstructive pulmonary disease, pulmonary tuberculosis and HIV infection: a comparative analysis. Vestnik Sovremennoi Klinicheskoi Meditsiny=Bulletin of Modern Clinical Medicine. 2025;18(2):68-74. (In Russ.).

29. Tlais Kh., Anaev E.Kh., Knyazheskaya N.P., et al. Osobennosti techeniya khronicheskoi obstruktivnoi bolezni legkikh u patsientov s tuberkulezom legkikh i VICH-infektsiei. Pul'monologiia=Pulmonology. 2024;34(6):822-831. (In Russ.). https://doi.org/10.18093/0869-0189-2024-34-6-822-831

30. Rosen M.J., Lou Y., Kvale P.A., et al. Pulmonary function tests in HIV-infected patients without AIDS. Pulmonary Complications of HIV Infection Study Group. Am J Respir Crit Care Med. 1995;152(2):738-745. https://doi.org/10.1164/ajrccm.152.2.7543346

31. Kodirov D.A., Salokhiddinov Z.S. Epidemiology of chronic obstructive pulmonary disease in HIV-infected population. J. Art of medicine. International Medical Scientific Journal. 2022;2(1):25-34. https://doi.org/10.51847/AOIM_1400-0110_2022_2_1_4