Impact of cigarette smoking on mortality in HIV-positive and HIV-negative veterans
AIDS Education and Prevention
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 HIVnegative 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. © 2009 The Guilford Press.
Crothers, K., Goulet, J., Rodriguez-Barradas, M., Gibert, C., Oursler, K., Goetz, M., Crystal, S., Leaf, D., Butt, A., Braithwaite, R., Peck, R., & Justice, A. (2009). Impact of cigarette smoking on mortality in HIV-positive and HIV-negative veterans. AIDS Education and Prevention, 21 (SUPPL. 3). http://dx.doi.org/10.1521/aeap.2009.21.3_supp.40