Smoking-related health risks among persons with HIV in the Strategies for Management of Antiretroviral Therapy clinical trial.
Smoking-related health risks among persons with HIV in the Strategies for Management of Antiretroviral Therapy clinical trial.
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DOI：
10.2105/ajph.2009.188664
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发表时间：
2010-10
影响因子：
12.7
通讯作者：
INSIGHT SMART Study Group
中科院分区：
文献类型：
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作者：
Lifson AR;Neuhaus J;Arribas JR;van den Berg-Wolf M;Labriola AM;Read TR;INSIGHT SMART Study Group
我们试图确定吸烟相关的危害比（HR）和人群归因于严重的临床事件和死亡的风险百分比（PAR%）的HIV阳性者，吸烟率高于一般人群。我们对来自33个国家的5472名HIV感染者进行了抗逆转录病毒治疗管理策略临床试验，评估了基线吸烟状况与艾滋病相关或严重非艾滋病事件的发生和总死亡率之间的关系。在所有参与者中，40.5%是当前吸烟者，24.8%是前吸烟者。目前吸烟者的总死亡率（2.4; P<.001）、主要心血管疾病（2.0; P=.002）、非艾滋病癌症（1.8; P=.008）和细菌性肺炎（2.3; P<.001）的调整后HR高于从不吸烟者。调整后的HR也显着高于这些结果之间的当前吸烟者比前。当前吸烟者与既往吸烟者和从不吸烟者的PAR%合计，总死亡率为24.3%，主要心血管疾病为25.3%，非AIDS癌症为30.6%，细菌性肺炎为25.4%。吸烟导致艾滋病毒感染人群的发病率和死亡率很高。提供者应定期将戒烟计划纳入艾滋病毒卫生保健。
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.