In our multivariable regression model, airway remodeling was associated with greater BMI, higher CD4 counts, and higher sCD163 levels, suggesting that macrophage activation from chronic immune activation [25, 26] and obesity may both play a role in airway remodeling, but the degree to which they are related is unclear [52, 53]. This evidence concerns the gene CD4 and obesity due to melanocortin 4 receptor deficiency.