SoSoGay – January 8th 2015

A recent study published in the AIDS journal reported that smoking doubles the mortality risk for people with HIV taking antiretroviral therapy. Smokers showed an increased risk of death from cardiovascular diseases and non-AIDS-related cancers. The researchers calculated that 35 year-old non-smokers had a life expectancy of 78 years. This compared to a life expectancy of 69 years for former smokers, and a life expectancy of just 63 years for current smokers.

Two years ago, a study from Denmark showed that smoking has a bigger impact on the life expectancy of people living with HIV than the HIV itself. It reported that an individual living with HIV who has never smoked could expect to live five years fewer than someone in the general population. However, someone living with HIV who smokes would live 12 years fewer.

Thanks to antiretroviral therapy, the prognosis for many people living with HIV is now excellent. Rates of HIV-related illnesses and deaths have fallen dramatically since the mid 1990s, meaning that lifestyle-related factors are now a major cause of morbidity and mortality in people living with UK.

‘The loss of life-years associated with smoking was larger than that associated with HIV,’ the researchers say. ‘HIV-infected smokers with long-term engagement in care lose more life-years to smoking than HIV.’

The same researchers from the Danish study have analysed data on deaths and smoking in around 18,000 people in Europe and North America over a 14-year period. Everyone in the study was living with HIV and taking anti-HIV drugs. They analysed information relating to approximately 18,000 people in Europe and North America who started HIV therapy between 1996 and 2008. All were followed for at least a year after starting therapy, and collectively they contributed approximately 80,000 person-years of follow-up. Most of the patients (60 per cent) were smokers; the overall mortality rate was 7.9 per 1000 person-years for smokers – but just 4.2 per 1000 person-years for non-smokers, meaning that smokers had twice the mortality risk compared to non-smokers.

The increase in deaths was mostly due to cardiovascular disease (heart attacks, strokes, etc), lung cancer, other cancers, and liver disease – 71 per cent of the recorded deaths had no relation to HIV.
The researchers concluded: ‘HIV-infected individuals with long-term engagement in care may lose more life years through smoking and associated lifestyle factors than through HIV. Interventions for stopping smoking cessation should be prioritised.’

Read the article on the SoSoGay site here.