Quach LA, Tang AM, Schmid CH, Gorbach SL, Wanke C. The role of cigarette smoking on HIV/AIDS mortality. 4th IAS Conference on HIV Pathogenesis, Treatment and Prevention incorporating the 19th ASHM Conference, July 22-25, 2007, Sydney, Australia.
Abstract #TUPEB096.
Objectives: To examine the role of smoking along with other traditional markers on mortality in HIV-positive patients.
Methods: 559 HIV-positive men and women from Boston and Providence in the US were recruited and followed in the cohort study “Nutrition for Healthy Living” from January 1997 to June 2005. Death certificates were obtained. The risk factors (CD4 count; viral load; chronic diarrhea; current HAART use; depression; illicit drug use; smoking status; the Body Mass Index (BMI); hemoglobin; cholesterol; AIDS) for mortality and other demographic characteristics were measured every six months. Kaplan-Meier survival curves and Cox Proportional Hazards analysis were performed and stepwise regression was conducted to select the final predictors of mortality. SAS version 9 was used for all analyses with P-value <0.05 for significance.
Results: The average age of the study population was 41. The percentage of females was 30% and 53% were Caucasian. Nearly two thirds of the participants were diagnosed with AIDS at baseline and 66% of the study population were on HAART. Current smokers had 2.5 times higher hazard ratio of mortality compared to the non smokers adjusting for other covariates (CI: 1.1 - 5.7). An increase of 100 cell/mm3 of CD4 decreased the hazard ratio of mortality by 0.7 times (CI:0.7 – 0.9). Those with BMI less than 20 kg/m2 had a 2.3 times higher hazard ratio of mortality compared to those whose BMI was from 20 to 25 kg/m2 (CI:1.0 - 5.4). Each one log increase in viral load increased the hazard ratio of mortality by 1.6 (CI:1.2 - 2.0). The hazard ratio of mortality was 2.2 times higher among inject drug users compared to non injecting drug users (CI: 1.2-3.9).
Conclusions: Smoking status is strongly associated with mortality in HIV infected patients. Introduction of smoking cessation programs may have a beneficial effect on outcomes in HIV infected patients.
