Semin Respir Crit Care Med 2016; 37(02): 181-198
DOI: 10.1055/s-0036-1572556
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Epidemiology of HIV-Associated Lung Disease in the United States

Meghan Fitzpatrick
1   Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
,
John T. Brooks
2   Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
,
Jonathan E. Kaplan
3   Division of Global HIV and TB, Centers for Disease Control and Prevention, Atlanta, Georgia
› Author Affiliations
Further Information

Publication History

Publication Date:
14 March 2016 (online)

Abstract

The epidemiology of HIV infection and its pulmonary complications in the United States has evolved significantly over nearly 20 years since the advent of combination antiretroviral therapy. While infectious complications are less of a threat to patients whose immune systems have been restored, many HIV-infected persons in the United States remain at high risk for opportunistic infection because they are unaware of their HIV infection, have difficulty maintaining linkage to care, or maintain inadequate viral control. Bacterial pneumonia and Pneumocystis pneumonia remain significantly more prevalent among HIV-infected persons, and together with seasonal influenza are areas where public health efforts to increase antiretroviral therapy, appropriate prophylaxis, and vaccination may decrease burden of disease. Noninfectious pulmonary complications of chronic HIV infection are increasingly recognized in the United States and elsewhere. Chronic obstructive pulmonary disease, asthma, pulmonary hypertension, sleep-disordered breathing, and primary lung cancer may all be more common among persons with HIV; of concern, disease burden in U.S. HIV-infected persons may be underestimated due to lack of diagnostic testing for these conditions. Smoking is among the most prevalent preventable causes of morbidity and mortality affecting persons living with HIV infection, and has particular import to pulmonary disease. As of 2009, 42% of HIV-infected adults in medical care in the United States smoked tobacco (over twice the national rate in the general population). Successful efforts to promote smoking cessation among HIV-infected persons are of critical importance to decrease the burden of chronic pulmonary disease.

Note

The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the U.S. Centers for Disease Control and Prevention or the National Institutes of Health.


 
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