Clinical features of the course of chronic obstructive pulmonary disease in HIV-infected patients and the impact of smoking on the course of COPD in this category of patients

Abstract Objective: To study the clinical features of chronic obstructive pulmonary disease in HIV-infected patients and to assess the role of smoking in the development of respiratory and immune disorders. Materials and Methods: A total of 33 patients were examined, divided into two comparable groups. The first group included 15 individuals with co-infection with HIV and COPD, and the second (control) group included 18 patients with COPD but not HIV. The patient's condition was assessed using the mMRC and CAT scales, spirometry. Laboratory tests included CD4+ lymphocyte counts, viral load, and inflammatory markers (CRP, fibrinogen). Statistical analysis was performed using the Mann-Whitney and Fisher tests, as well as the Spearman correlation coefficient. Results. Patients with HIV infection had a higher smoking intensity (27.2 pack-years) and a significantly lower body mass index. A strong direct association between smoking intensity and the frequency of COPD exacerbations (r = 0.76) and an inverse association with CD4+ immune cell levels (r = -0.71) were found. Tobacco smoke was found to maintain high levels of systemic inflammation and contribute to an increase in viral load in the blood. Conclusions. The course of COPD in HIV-infected patients is characterized by early onset, severe dyspnea, and rapid destruction of lung tissue. Smoking is a key factor that not only damages the lungs but also suppresses the immune system, reducing the effectiveness of HIV treatment. These findings highlight the critical importance of smoking cessation programs for preserving the lives and health of HIV-infected patients. Keywords: HIV infection, chronic obstructive pulmonary disease, smoking, pack-years, immunity. Conflict of interest: None declared.