Obstructive lung disease and HIV/AIDS in the HAART era.

Early in the AIDS epidemic opportunistic lung infections, most notably Pneumocystis infection, dominated the clinical picture and were the most common cause of death in HIV-infected individuals. With the progressive development of effective antiretroviral treatments and prophylaxis against Pneumocystis, the prognosis in HIV/AIDS has improved dramatically with median survival now greater than a decade. However, lung infections from opportunistic, as well as typical bacterial pathogens remain a major cause of morbidity and are still the leading cause of death from HIV/AIDS. In addition, as the survival of infected individuals has increased, it is becoming apparent that other more-chronic lung diseases, including emphysema and cancer, are more common in these individuals. Although the mechanisms by which HIV/AIDS increases the risk of both infectious and noninfectious lung diseases are still being investigated, there is emerging evidence from clinical and experimental studies that HIV causes oxidant stress w...