Conley L J, Bush T J, Buchbinder S P, Penley K A, Judson F N, Holmberg S D
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
AIDS. 1996 Sep;10(10):1121-6.
To clarify the effect of cigarette smoking on the development of conditions associated with HIV infection.
Prospective and retrospective cohort study, with interview and examination twice a year since 1988.
Data on 516 HIV-infected men from cohorts of homosexual and bisexual men in San Francisco, Denver and Chicago, who were repeatedly interviewed and examined between 1988 and 1992, were analysed. After excluding men who did not have well-defined dates of seroconversion and those who were classified as ex- or intermittent smokers, 232 men remained for analysis: 106 were smokers and 126 were non-smokers. Univariate and Kaplan-Meier survival analyses were performed to assess the relationship between cigarette smoking and loss of CD4+ T-lymphocytes, diagnosis of any AIDS-defining illness, and specific diagnosis of Kaposi's sarcoma, Pneumocystis carinii pneumonia (PCP), oral candidiasis, hairy leukoplakia, and community-acquired pneumonia.
By univariate analyses, cigarette smoking was not associated with clinical AIDS, loss of CD4+ cells, Kaposi's sarcoma or PCP, but was significantly associated with oral candidiasis [relative risk (RR), 1.32; 95% confidence interval (CI), 1.02-1.70], hairy leukoplakia (RR, 1.51; 95% CI, 1.15-1.99), and community-acquired pneumonia (RR, 2.62; 95% CI, 1.30-5.27). Dose-response effect was also evident for these three conditions (all P < 0.01). Kaplan-Meier survival analysis indicated no association between cigarette smoking and time of progression to clinical AIDS, Kaposi's sarcoma (KS), or PCP (P = 0.62, 0.54 and 0.11, respectively) but showed that cigarette smokers developed oral candidiasis, hairy leukoplakia, and pneumonia more quickly than non-smokers (P = 0.031, 0.006 and 0.009, respectively).
Cigarette smoking was not associated with an increased likelihood or rate of developing KS, PCP or AIDS, but was associated with developing community-acquired pneumonia, oral candidiasis, and hairy leukoplakia in these HIV-infected men.
阐明吸烟对与HIV感染相关疾病发展的影响。
前瞻性和回顾性队列研究，自1988年起每年进行两次访谈和检查。
分析了来自旧金山、丹佛和芝加哥同性恋及双性恋男性队列中516名HIV感染男性的数据，这些男性在1988年至1992年间接受了多次访谈和检查。排除血清转化日期不明确的男性以及被归类为既往吸烟者或间歇性吸烟者后，剩余232名男性进行分析：106名吸烟者和126名非吸烟者。进行单因素分析和Kaplan-Meier生存分析，以评估吸烟与CD4+T淋巴细胞减少、任何艾滋病定义疾病的诊断以及卡波西肉瘤、卡氏肺孢子虫肺炎（PCP）、口腔念珠菌病、毛状白斑和社区获得性肺炎的具体诊断之间的关系。
单因素分析显示，吸烟与临床艾滋病、CD4+细胞减少、卡波西肉瘤或PCP无关，但与口腔念珠菌病显著相关[相对风险（RR），1.32；95%置信区间（CI），1.02 - 1.70]、毛状白斑（RR，1.51；95%CI，1.15 - 1.99）和社区获得性肺炎（RR，2.62；95%CI，1.30 - 5.27）。这三种情况也存在剂量反应效应（所有P<0.01）。Kaplan-Meier生存分析表明，吸烟与进展至临床艾滋病、卡波西肉瘤（KS）或PCP的时间无关（P分别为0.62、0.54和0.11），但表明吸烟者比非吸烟者更快出现口腔念珠菌病、毛状白斑和肺炎（P分别为0.031、0.006和0.009）。
吸烟与这些HIV感染男性发生KS、PCP或艾滋病的可能性或发生率增加无关，但与发生社区获得性肺炎、口腔念珠菌病和毛状白斑有关。
