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

Kristina Crothers, Joseph L. Goulet, Maria C. Rodriguez-Barradas, Cynthia L. Gibert, Kris Ann K. Oursler, Matthew Bidwell Goetz, Stephen Crystal, David A. Leaf, Adeel A. Butt, R. Scott Braithwaite, Robin Peck, Amy C. Justice

Research output: Contribution to journalArticlepeer-review

85 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)40-53
Number of pages14
JournalAIDS Education and Prevention
Volume21
Issue numberSUPPL. 3
DOIs
StatePublished - Jun 2009

All Science Journal Classification (ASJC) codes

  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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