Altered Polarization and Impaired Phagocytic Activity of Lung Macrophages in People With Human Immunodeficiency Virus and Chronic Obstructive Pulmonary Disease

Background People with human immunodeficiency virus (PWH) have an increased risk of developing chronic obstructive pulmonary disease (COPD). Methods We phenotyped lung macrophages in 4 subgroups-M1 (CD40(+)CD163(-)), M2 (CD40(-)CD163(+)), double positives (CD40(+)CD163(+)), and double negatives and (CD40(-)CD163(-))-and we determined their phagocytic capacity in PWH with and without COPD. Results People with human immunodeficiency virus with COPD have more double-negative macrophages (84.1%) versus PWH without (54.3%) versus controls (23.9%) (P=.004) and reduced phagocytosis (P=.012). Double-negative macrophages had the worst phagocytic capacity (P<.001). Conclusions People with human immunodeficiency virus with COPD have an abundance of nonpolarized macrophages, which have poor phagocytic capacity and therefore predispose PWH to increased risk of disease progression. People with HIV (PWH) have an increased risk of developing chronic obstructive pulmonary disease (COPD). PWH with COPD have an abundance of nonpolarized macrophages, which have poor phagocytic capacity and therefore predispose PWH to increased risk of disease progression.