Smoking-related health risks among persons with HIV in the Strategies for Management of Antiretroviral Therapy clinical trial
Alan R Lifson, Jacqueline Neuhaus, Jose Ramon Arribas, Mary van den Berg-Wolf, Ann M Labriola, Timothy R H Read, INSIGHT SMART Study Group, Alan R Lifson, Jacqueline Neuhaus, Jose Ramon Arribas, Mary van den Berg-Wolf, Ann M Labriola, Timothy R H Read, INSIGHT SMART Study Group
Abstract
Objectives: We sought to determine smoking-related hazard ratios (HRs) and population-attributable risk percentage (PAR%) for serious clinical events and death among HIV-positive persons, whose smoking prevalence is higher than in the general population.
Methods: For 5472 HIV-infected persons enrolled from 33 countries in the Strategies for Management of Antiretroviral Therapy clinical trial, we evaluated the relationship between baseline smoking status and development of AIDS-related or serious non-AIDS events and overall mortality.
Results: Among all participants, 40.5% were current smokers and 24.8% were former smokers. Adjusted HRs were higher for current than for never smokers for overall mortality (2.4; P < .001), major cardiovascular disease (2.0; P = .002), non-AIDS cancer (1.8; P = .008), and bacterial pneumonia (2.3; P < .001). Adjusted HRs also were significantly higher for these outcomes among current than among former smokers. The PAR% for current versus former and never smokers combined was 24.3% for overall mortality, 25.3% for major cardiovascular disease, 30.6% for non-AIDS cancer, and 25.4% for bacterial pneumonia.
Conclusions: Smoking contributes to substantial morbidity and mortality in this HIV-infected population. Providers should routinely integrate smoking cessation programs into HIV health care.
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Source: PubMed