Yale University

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

TitleImpact of cigarette smoking on mortality in HIV-positive and HIV-negative veterans.
Publication TypeJournal Article
Year of Publication2009
AuthorsCrothers, Kristina, Joseph L. Goulet, Maria C. Rodriguez-Barradas, Cynthia L. Gibert, Krisann K. Oursler, Matthew Bidwell Goetz, Stephen Crystal, David A. Leaf, Adeel A. Butt, Scott R. Braithwaite, Robin Peck, and Amy C. Justice
JournalAIDS education and prevention : official publication of the International Society for AIDS Education
Issue3 Suppl
Date Published2009 Jun
KeywordsAdult, Anti-HIV Agents, CD4 Lymphocyte Count, Cohort Studies, Comorbidity, Female, HIV Infections, HIV Seronegativity, HIV Seropositivity, HIV-1, Humans, Male, Middle Aged, Proportional Hazards Models, Quality of Life, Smoking, Survival Analysis, United States, Veterans, Viral Load
AbstractIt 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.
Alternate JournalAIDS Educ Prev

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