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HIV infection results in a CD8+ T cell alveolitis that is only partially reversed by antiretroviral therapy (ART) and is thought to contribute to an increased risk of chronic obstructive pulmonary disease (COPD). Smoking is the single greatest risk factor for development of COPD and is closely associated with CD8+ T cell accumulation in lung tissue. Although 70% of HIV-infected individuals smoke, the lung immune response against HIV in the context of smoking has not been well characterized. HIV-infected and uninfected subjects on ART who were current and never smokers underwent bronchoscopy with bronchoalveolar lavage (BAL) and airway brushing (n= 23 HIV-negative never smokers; n= 7 HIV-negative smokers; n= 14 HIV-infected never smokers; and n= 13 HIV-infected smokers). Lung and blood immune cells were analyzed using flow cytometry. Monocyte derived macrophages (MDMs …