Given that: 1) systemic inflammation is commonly observed in patients with COPD [32], 2) COPD is a risk factor for bacterial pneumonia [33], [34] and 3) HIV infection is an independent risk factor for COPD [35], we cannot exclude the possibility that the risk associated with elevated hsCRP, IL-6, and d-dimer levels we observed might reflect underlying lung disease. Here, IL6 is linked to HIV infectious disease.