Petoumenos Kathy, Law Matthew G
The Kirby Institute, UNSW Australia, Sydney, Australia.
Curr Opin HIV AIDS. 2016 Sep;11(5):514-520. doi: 10.1097/COH.0000000000000306.
In the era of effective antiretroviral therapy, HIV-positive patients experience an increase in non-AIDS associated comorbidities. Causes of death are now more frequently associated with ageing and smoking; alcohol and drug use are strongly linked to many of these causes.
An almost equal life expectancy among HIV-positive people compared with HIV-negative population has been recently reported. However, life expectancy is reduced among HIV-positive smokers by at least 16 years and further reduced for people who have a history of excessive alcohol and drug use. Cohort studies report between a 1.5- and two-fold or greater increased mortality risk as a result of smoking. In a Danish population study, 61% of deaths in HIV-positive people were associated with smoking. Excessive alcohol and drug use are also elevated among specific HIV subpopulations and significantly impact morbidity and mortality. In the Veteran Affairs cohort study, moderate and excessive alcohol use increased mortality by 25-35% compared with low alcohol use.
Despite the effective therapy, smoking, alcohol and drug use have a significant role in increased mortality and reduced life expectancy among HIV-positive people. These factors need to be in continued focus for the management and care of HIV-positive people.
在有效的抗逆转录病毒治疗时代，HIV阳性患者非艾滋病相关合并症有所增加。目前，死亡原因更常与衰老和吸烟相关；饮酒和吸毒与其中许多原因密切相关。
最近有报道称，HIV阳性人群与HIV阴性人群的预期寿命几乎相等。然而，HIV阳性吸烟者的预期寿命至少缩短16年，有过量饮酒和吸毒史的人预期寿命进一步缩短。队列研究报告称，吸烟导致的死亡风险增加1.5至两倍或更高。在一项丹麦人群研究中，HIV阳性人群中61%的死亡与吸烟有关。特定HIV亚人群中过量饮酒和吸毒的情况也有所增加，对发病率和死亡率有显著影响。在退伍军人事务队列研究中，与少量饮酒相比，中度和过量饮酒使死亡率增加25%至35%。
尽管有有效的治疗方法，但吸烟、饮酒和吸毒在增加HIV阳性人群的死亡率和缩短预期寿命方面仍起着重要作用。在对HIV阳性人群的管理和护理中，这些因素需要持续关注。
