Smoking is particularly hazardous for individuals with HIV infection
Research Activities, December 2009, No. 352
Everyone knows smoking is a leading cause of death and disease. But for persons living with HIV, smoking is particularly hazardous, concludes a study of veterans. Researchers compared overall mortality in 1,034 HIV-positive veterans and 739 HIV-negative veterans. Both groups were matched according to age, race, sex, and demographics. Information was obtained on smoking status (current or former smoker), the number of pack-years (based on cigarettes smoked per day and years), coexisting diseases, respiratory symptoms, substance abuse, and quality of life. They were followed for a median of 5.3 years.
There were 200 deaths in the HIV-positive group, resulting in a mortality rate of 4.1 per 100 person-years (PY). This was double the mortality rate of 2.0 per 100 PY (72 deaths) in the HIV-negative group. However, HIV-positive current smokers had the highest mortality rate of 5.48 per 100 PY, followed by 3.41 for HIV-positive former smokers, and 2.45 for never smokers infected with HIV. When the researchers stratified patients by pack-years of smoking, there was a decreased survival among HIV-positive veterans with any degree of smoking exposure. Mortality rates were significantly higher in HIV-positive smokers compared with HIV-positive veterans who never smoked for both less than 20 and greater than or equal to 20 pack-years of exposure. Smoking was also linked to increased respiratory symptoms and coexisting diseases, as well as a decreased quality of life.
The researchers recommend that encouraging individuals with HIV infection to quit smoking, regardless of pack-year history, should be an important part of their ongoing care. The study was supported in part by the Agency for Healthcare Research and Quality (HS16097).
See "Impact of cigarette smoking on mortality in HIV-positive and HIV-negative veterans," by Kristina Crothers, M.D., Joseph L. Goulet, Ph.D., M.S., Maria C. Rodriguez-Barradas, M.D. and others, in the 2009 AIDS Education and Prevention 21(Suppl A), pp. 40-53.