HIV Patients in Care Lose More Years of Life to Smoking Than to HIV Infection
Findings emphasize importance of patient counseling to stop smoking in integrated HIV care
DEC. 19, 2012 - Among HIV patients receiving well-organized care with free access to antiretroviral therapy,
those who smoke lose more years of life to smoking than to HIV, according to a Danish study published in Clinical
Infectious Diseases and available online . The
findings highlight the importance of smoking cessation efforts in the long-term, integrated care of patients infected with HIV.
Marie Helleberg, MD, of Copenhagen University Hospital and colleagues estimated the effect of smoking on mortality, risk
of death, and life expectancy, and the number of life years lost to smoking compared to years lost to HIV among nearly 3,000
HIV-infected patients treated in Denmark from 1995 to 2010. They also compared mortality associated with smoking between
HIV patients and the country's background population. Where HIV care is integrated and antiretroviral therapy is
available at no cost, "more than 60 percent of deaths among HIV patients are associated with smoking," rather
than HIV, Dr. Helleberg said.
Estimated life expectancy differed significantly based on smoking status. A 35-year-old HIV patient who currently smokes had a
life expectancy of 62.6 years, compared to 78.4 years for a nonsmoker infected with HIV. The loss of years of life associated
with smoking was twice as high as that associated with HIV among HIV-infected patients. In addition, researchers found the
excess mortality of HIV-infected smokers to be three times higher than that of individuals not infected with HIV.
"Our findings emphasize the importance of counseling HIV patients on smoking cessation as smoking may impact their life
expectancy considerably more than the HIV infection itself," the study authors wrote. The results also underscore the importance
of prioritizing interventions for stopping smoking in HIV patient care and for the general population. Smokers who stop see
their risk of cardiovascular disease drop rather quickly, but they remain at increased risk of cancer until several years
The emphasis on well-organized HIV care is crucial, according to Dr. Helleberg and her team. Continuing to smoke-or starting the
habit-poses extra risks for patients with HIV. Patients who receive integrated care from a variety of health care professionals,
including those who can help patients address lifestyle issues, can find support for decisions to stop smoking.
Mortality Attributable to Smoking Among HIV-1-Infected Individuals: A Nationwide, Population-Based Cohort Study
Clinical Infectious Diseases is a leading journal in the field of infectious disease with a broad international readership. The journal publishes articles on a variety of subjects of interest to practitioners and researchers. Topics range from clinical descriptions of infections, public health, microbiology, and immunology to the prevention of infection, the evaluation of current and novel treatments, and the promotion of optimal practices for diagnosis and treatment. The journal publishes original research, editorial commentaries, review articles, and practice guidelines and is among the most highly cited journals in the field of infectious diseases. Clinical Infectious Diseases is an official publication of the Infectious Diseases Society of America (IDSA). Based in Arlington, Va., IDSA is a professional society representing nearly 10,000 physicians and scientists who specialize in infectious diseases. For more information, visit www.idsociety.org .
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Infectious Diseases Society of America (IDSA)
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