Based on recent studies demonstrating the importance of IL-23 and the Th17 immune response in the development of chronic obstructive pulmonary disease [13–15], their role in the progression of HIV-1 infection [16–20], and the effect of IL-23 on increased lung MMP-9 in mice [21], we focused on a possible role of IL-23 in the upregulation of MMP-9 in AM of HIV1+ smokers. This evidence concerns the gene IL23A and chronic obstructive pulmonary disease.