HIV Survival rates of patients with HIV have improved enormously as a result of antiretroviral therapy, but increased life expectancy is now associated with a high risk of comorbidities. HIV–1-associated chronic obstructive pulmonary disease (COPD) often manifests as emphysema, originating around the airways and extending into lung tissue. Chung et al. have discovered that this is caused by HIV binding to basal cells in the airway and activating a tissue-destructive phenotype through a mitogen-activated protein kinase signaling cascade. HIV binding triggers up-regulation of matrix metalloproteinase 9, which is known to be elevated in COPD patients and may contribute to the degradation of extracellular matrix seen in emphysema sufferers. Cell Rep. 19 , 1091 (2017).