Impact of cigarette smoking on mortality in HIV-positive and HIV-negative veterans

• Published in: AIDS education and prevention Vol. 21; no. A(Supp.); pp. 40 - 53
• Main Authors: Crothers, Kristina, Goulet, Joseph L, Rodriguez-Barradas, Maria C, Gilbert, Cynthia L, Oursler, Kris Ann K, Goetz, Matthew Bidwell, Crystal, Stephen, Leaf, David A, Butt, Adeel A, Braithwaite, R Scott, Peck, Robin, Justice, Amy C
• Format: Journal Article
• Language: English
• Published: 01.06.2009
• Subjects: AIDS; Effects; Health; Health promotion; HIV; Mortality; Prevention; Smoking
• ISSN: 0899-9546

It is unknown whether smoking confers similar mortality risk in HIV-positive as in HIV-negative patients. We compared overall mortality stratified by HIV and smoking of 1,034 HIV-positive block-matched to 739 HIV-negative veterans, enrolled 2001-2002 in the Veterans Aging Cohort 5 Site Study. Adjusted incidence rate ratios (IRR) for mortality were calculated using Poisson regression. Mortality was significantly increased in HIV-positive veterans according to both smoking status and pack-years in unadjusted and adjusted analyses (adjusted IRR 2.31, 95% confidence interval [CI] 1.53-3.49 for HIV-positive current smokers and IRR 1.32, 95% CI 0.67-2.61 for HIV-negative current smokers). Comorbid diseases were also significantly increased according to smoking status and pack-years. Current smoking is associated with poor outcomes; even lower levels of exposure appear to be detrimental in HIV-infected veterans. These findings support the need for improvements in smoking cessation and for studies of mechanisms and diseases underlying increased mortality in smokers with HIV. Reprinted by permission of Guilford Publications Inc., New York City