[pronut-hiv] Cigarette Smoking and HIV Prognosis Among Women in the HAART Era

["ProNut-HIV" <pronut-hiv@healthnet.org>]

Association of Cigarette Smoking With HIV Prognosis Among Women in the
HAART Era: A Report From the Women's Interagency HIV Study

Joseph G. Feldman, DrPH; Howard Minkoff, MD; Michael F. Schneider, MS;
Stephen J. Gange, PhD; Mardge Cohen, MD; D. Heather Watts, MD; Monica
Gandhi, MD; Robert S. Mocharnuk, MD; Kathryn Anastos, MD 

Abstract
Objective: We assessed the association of cigarette smoking with the
effectiveness of highly active antiretroviral therapy (HAART) among
low-income women.
Methods: Data were analyzed from the Women's Interagency HIV Study, a
multisite longitudinal study up to 7.9 years for 924 women representing
72% of all women who initiated HAART between July 1, 1995, and September
30, 2003.
Results: When Cox's regression was used after control for age, race,
hepatitis C infection, illicit drug use, previous antiretroviral
therapy, and previous AIDS, smokers on HAART had poorer viral responses
(hazard ratio [HR] = 0.79; 95% confidence interval [CI] = 0.67, 0.93)
and poorer immunologic response (HR = 0.85; 95% CI = 0.73, 0.99). A
greater risk of virologic rebound (HR = 1.39; 95% CI = 1.06, 1.69) and
more frequent immunologic failure (HR = 1.52; 95% CI = 1.18, 1.96) were
also observed among smokers. There was a higher risk of death (HR =
1.53; 95% CI = 1.08, 2.19) and a higher risk of developing AIDS (HR =
1.36; 95% CI = 1.07, 1.72) but no significant difference between smokers
and nonsmokers in the risk of death due to AIDS.
Conclusions: Some of the benefits provided by HAART are negated in
cigarette smokers.


Am J Public Health.  2006;96(6):1060-1065.