Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55454-1015, USA.
Am J Public Health. 2010 Oct;100(10):1896-903. doi: 10.2105/AJPH.2009.188664. Epub 2010 Aug 19.
We sought to determine smoking-related hazard ratios (HRs) and population-attributable risk percentage (PAR%) for serious clinical events and death among HIV-positive persons, whose smoking prevalence is higher than in the general population.
For 5472 HIV-infected persons enrolled from 33 countries in the Strategies for Management of Antiretroviral Therapy clinical trial, we evaluated the relationship between baseline smoking status and development of AIDS-related or serious non-AIDS events and overall mortality.
Among all participants, 40.5% were current smokers and 24.8% were former smokers. Adjusted HRs were higher for current than for never smokers for overall mortality (2.4; P < .001), major cardiovascular disease (2.0; P = .002), non-AIDS cancer (1.8; P = .008), and bacterial pneumonia (2.3; P < .001). Adjusted HRs also were significantly higher for these outcomes among current than among former smokers. The PAR% for current versus former and never smokers combined was 24.3% for overall mortality, 25.3% for major cardiovascular disease, 30.6% for non-AIDS cancer, and 25.4% for bacterial pneumonia.
Smoking contributes to substantial morbidity and mortality in this HIV-infected population. Providers should routinely integrate smoking cessation programs into HIV health care.
我们旨在确定 HIV 阳性人群中与吸烟相关的严重临床事件和死亡的危害比（HR）和人群归因风险百分比（PAR%），因为该人群的吸烟率高于普通人群。
我们评估了 33 个国家的 5472 名 HIV 感染者在接受抗逆转录病毒治疗管理策略临床试验时，基线吸烟状况与艾滋病相关或严重非艾滋病事件以及全因死亡率的关系。
所有参与者中，40.5%为当前吸烟者，24.8%为曾经吸烟者。与从不吸烟者相比，当前吸烟者的全因死亡率（2.4；P<0.001）、主要心血管疾病（2.0；P=0.002）、非艾滋病相关癌症（1.8；P=0.008）和细菌性肺炎（2.3；P<0.001）的调整 HR 更高。与从不吸烟者和曾经吸烟者相比，当前吸烟者的这些结局的调整 HR 也显著更高。当前吸烟者与曾经吸烟者和从不吸烟者相比，全因死亡率、主要心血管疾病、非艾滋病相关癌症和细菌性肺炎的 PAR%分别为 24.3%、25.3%、30.6%和 25.4%。
吸烟导致 HIV 感染人群发病率和死亡率显著增加。提供者应将戒烟计划常规纳入 HIV 保健中。
