Consequences of tobacco in patients living with HIV
December 30, 2019
Par: webstudio_editor
Dernière mise à jour: December 30, 2019
Temps de lecture: 3 minutes
As antiviral treatments improve the survival of patients living with HIV, the mortality of these patients from noncommunicable diseases (NCDs) becomes more frequent. As the WHO recalls, smoking is the main risk factor for NCDs for the general population and also for patients living with HIV.
The morbidity and mortality associated with smoking are all the more significant in these patients since, on the one hand, the prevalence of smoking is higher in them than in the general population, and on the other hand, certain antiviral treatments, through metabolic disturbances, increase the risk of NCDs, particularly cardiovascular. Overall, for people on antiretroviral treatment with an undetectable viral load, smoking has a greater impact on life expectancy than HIV infection..
On the other hand, smoking does not affect HIV infection, its progression and the CD4 cell count.[1] compared to non-smokers
Cardiovascular risk in HIV-infected patients is aggravated by smoking (+ or – use of other psychoactive substances), exposure to antiretrovirals and the specific effects of HIV infection. Quitting smoking significantly reduces the risk of developing cardiovascular disease.[2]-[3].
With identical tobacco consumption, the occurrence of chronic obstructive pulmonary disease (COPD) is more frequent and earlier in HIV-positive subjects than in uninfected subjects, and the same is true for lung cancer, the risk of which in the infected population is 2 to 6 times higher than that of the general population of the same age and sex.[4]-[5].
Finally, the frequency of bacterial pneumonia is increased in patients infected with HIV and particularly in smokers.
Overall, mortality linked to HIV infection does not differ between smokers and non-smokers, however, smoking patients have excess mortality compared to non-HIV-infected smokers.
©Generation Without Tobacco
[1] The goal of a virus is to reproduce (multiply); to do this, it absolutely must use a cell in the human body. For example, the flu virus associates with cells in the lungs. In the case of HIV, it uses cells in the immune system called CD4 cells. The role of CD4 cells is to coordinate the immune system. By using these cells, HIV lowers the number of CD4 cells and therefore causes a weakening of the immune system. [2] Butt AA, Chang CC, et al. ”Risk of heart failure with human immunodeficiency virus in the absence of prior diagnosis of coronary heart disease”. Arch Intern Med. 2011; 171:737–743. [3] Subramanian S, et al. Arterial inflammation in patients with HIV. JAMA. 2012; 308:379–386 [4] Sigel, Keith et al. “Lung cancer in persons with HIV.” Current opinion in HIV and AIDS vol. 12.1 (2017): 31-38. doi:10.1097/COH.00000000000000326 [5] Sigel, Keith et al. “HIV as an independent risk factor for incident lung cancer.” AIDS (London, England) vol. 26.8 (2012): 1017-25. doi:10.1097/QAD.0b013e328352d1ad ©National Committee Against Smoking |
