Universität zu Köln

Helleberg, Marie ORCID: 0000-0002-2370-1657, May, Margaret T., Ingle, Suzanne M., Dabis, Francois, Reiss, Peter, Faetkenheuer, Gerd, Costagliola, Dominique ORCID: 0000-0003-0765-0869, d'Arminio, Antonella, Cavassini, Matthias, Smith, Colette ORCID: 0000-0003-2847-3355, Justice, Amy C., Gill, John, Sterne, Jonathan A. C. and Obel, Niels (2015). Smoking and life expectancy among HIV-infected individuals on antiretroviral therapy in Europe and North America. Aids, 29 (2). S. 221 - 230. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1473-5571

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Abstract

Background: Cardiovascular disease and non-AIDS malignancies have become major causes of death among HIV-infected individuals. The relative impact of lifestyle and HIV-related factors are debated. Methods: We estimated associations of smoking with mortality more than 1 year after antiretroviral therapy (ART) initiation among HIV-infected individuals enrolled in European and North American cohorts. IDUs were excluded. Causes of death were assigned using standardized procedures. We used abridged life tables to estimate life expectancies. Life years lost to HIV were estimated by comparison with the French background population. Results: Among 17 995 HIV-infected individuals followed for 79 760 person-years, the proportion of smokers was 60%. The mortality rate ratio (MRR) comparing smokers with nonsmokers was 1.94 [95% confidence interval (95% CI) 1.56-2.41]. The MRRs comparing current and previous smokers with never smokers were 1.70 (95% CI 1.23-2.34) and 0.92 (95% CI 0.64-1.34), respectively. Smokers had substantially higher mortality from cardiovascular disease, non-AIDS malignancies than nonsmokers [MRR 6.28 (95% CI 2.19-18.0) and 2.67 (95% CI 1.60-4.46), respectively]. Among 35-year- old HIV-infected men, the loss of life-years associated with smoking and HIV was 7.9 (95% CI 7.1-8.7) and 5.9 (95% CI 4.9-6.9), respectively. The life expectancy of virally suppressed, never-smokers was 43.5 years (95% CI 41.7-45.3), compared with 44.4 years among 35-year-old men in the background population. Excess MRRs/1000 person-years associated with smoking increased from 0.6 (95% CI -1.3 to 2.6) at age 35 to 43.6 (95% CI 37.9-49.3) at age at least 65 years. Conclusion: Well treated HIV-infected individuals may lose more life years through smoking than through HIV. Excess mortality associated with smoking increases markedly with age. Therefore, increases in smoking-relatedmortality can be expected as the treated HIV-infected population ages. Interventions for smoking cessation should be prioritized. (C) 2015 Wolters Kluwer Health, Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Helleberg, Marie UNSPECIFIED orcid.org/0000-0002-2370-1657 UNSPECIFIED May, Margaret T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ingle, Suzanne M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dabis, Francois UNSPECIFIED UNSPECIFIED UNSPECIFIED Reiss, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Faetkenheuer, Gerd UNSPECIFIED UNSPECIFIED UNSPECIFIED Costagliola, Dominique UNSPECIFIED orcid.org/0000-0003-0765-0869 UNSPECIFIED d'Arminio, Antonella UNSPECIFIED UNSPECIFIED UNSPECIFIED Cavassini, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Smith, Colette UNSPECIFIED orcid.org/0000-0003-2847-3355 UNSPECIFIED Justice, Amy C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gill, John UNSPECIFIED UNSPECIFIED UNSPECIFIED Sterne, Jonathan A. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Obel, Niels UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-414693
DOI:	10.1097/QAD.0000000000000540
Journal or Publication Title:	Aids
Volume:	29
Number:	2
Page Range:	S. 221 - 230
Date:	2015
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1473-5571
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CIGARETTE-SMOKING; GENERAL-POPULATION; MORTALITY; DEATH; AIDS; ERA; MORBIDITY; BENEFITS; PEOPLE; IMPACT Multiple languages Immunology; Infectious Diseases; Virology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/41469