Monday, March 4, 2013

Smoking and HIV Don't Mix!

Source: drugfree.org
I am always bewildered by my HIV positive patients who are exceedingly concerned about their HIV viral loads, CD4 counts, dietary supplements, cholesterol profiles and healthy lifestyles, yet continue to smoke. 

Here is an article from Clinical Infectious Diseases on the attributable mortality of smoking in HIV positive patients.

A total of 2921 HIV patients and 10,642 controls were followed for 14 281 and 45 122 person-years, respectively. All-cause and non-AIDS-related mortality was substantially increased among smoking compared to nonsmoking HIV patients. A 35-year-old HIV patient had a median life expectancy of 62.6 years (95% CI, 59.9-64.6) for smokers and 78.4 years (95% CI, 70.8-84.0) for nonsmokers; the numbers of life-years lost in association with smoking and HIV were 12.3 (95% CI, 8.1-16.4) and 5.1 (95% CI, 1.6-8.5). The population-attributable risk of death associated with smoking was 61.5% among HIV patients and 34.2% among controls. 

Even when HIV care is well organized and antiretroviral therapy is free and accessible, HIV-infected smokers lose more life-years to smoking than to HIV.

The bottom line: among HIV infected smokers the rate of non-AIDS related death was raised >5 fold and the majority of these deaths were from cardiovascular (heart) disease and cancers.

If you are concerned about your health, quit smoking.