Microbial Ecological Instability and Non-Linear Host Interactions Shape Airway Inflammation in HIV-Associated COPD

Chronic Obstructive Pulmonary Disease (COPD) is increasingly prevalent among people infected with human immunodeficiency virus (HIV) in sub-Saharan Africa. Yet, the ecological and immunological mechanisms linking airway microbes to mucosal inflammation remain unclear. We performed multi-omics profiling in adults from rural Uganda stratified by HIV/COPD status, integrating sputum microbiome sequencing, outer membrane vesicle (OMV) quantification, cytokine profiling, CyTOF immunophenotyping, and bulk and single-cell transcriptomics with bronchoalveolar lavage (BAL)-guided deconvolution.