Findings emphasize importance of patient counseling to stop smoking in integrated HIV care
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.