Cigarette smoking, bacterial pneumonia, and other clinical outcomes in HIV-1 infection

被引:91
作者
Burns, DN
Hillman, D
Neaton, JD
Sherer, R
Mitchell, T
Capps, L
Vallier, WG
Thurnherr, MD
Gordin, FM
Johns, S
Ellison, J
Hickson, MJ
Lee, J
Thompson, M
Creagh, T
Morris, A
Ernst, J
POllard, C
Anastos, K
Bar, M
Doramajian, E
Blatt, D
Moore, D
Renzetti, R
Verheggen, R
LuskinHawk, R
Torres, RA
Townley, D
Clanon, K
Morris, B
Owen, W
Brosgart, C
Crane, LR
Ebright, J
Schuman, P
Vallier, W
Fairclough, C
Holloway, WJ
Winslow, D
Szabo, S
Bincsik, A
Swanson, K
Cohn, DL
Reves, RR
Grodesky, MJ
Mesard, CA
Gans, JE
ElSadr, W
Capps, L
Guity, C
机构
[1] VET AFFAIRS MED CTR,DIV INFECT DIS,WASHINGTON,DC 20422
[2] UNIV MINNESOTA,SCH PUBL HLTH,DIV BIOSTAT,MINNEAPOLIS,MN 55455
[3] COOK CTY HOSP,COOK CTY HIV PRIMARY CARE CTR,CHICAGO,IL 60612
[4] UNIV CALIF SAN FRANCISCO,SAN FRANCISCO GEN HOSP,AIDS PROGRAM,SAN FRANCISCO,CA
[5] COLUMBIA UNIV,DIV INFECT DIS,HARLEM HOSP CTR,NEW YORK,NY
[6] WAYNE STATE UNIV,DETROIT MED CTR,HIV AIDS UNIT,DETROIT,MI
[7] TEST POSIT AWARE NETWORK,CHICAGO,IL
来源
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES AND HUMAN RETROVIROLOGY | 1996年 / 13卷 / 04期
关键词
acquired immunodeficiency syndrome; disease progression; HIV; pneumonia; smoking;
D O I
10.1097/00042560-199612010-00012
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Cigarette smoking has been associated rvith impaired immune defenses and an increased risk of certain infectious and neoplastic diseases in HIV-1 seronegative populations. We examined the relationship between cigarette smoking and clinical outcome in a prospective cohort of 3221 HIV-1-seropositive men and women enrolled in the Terry: Beirn Community Programs for Clinical Research on AIDS, Differences in clinical outcomes between never, former, and current cigarette smokers were assessed using proportional hazards regression analysis. After adjustment fur CD4+ cell count. Drier disease progression, use of antiretroviral therapy, and other covariates, there was no difference between current smokers and never smokers in the overall risk of opportunistic diseases [relative hazard (RH) = 1.05: 95% confidence interval (CI) 0.9-1.23; p = 0.52] or death (RH = 1.00; 95% CI 0.86-1.18: p = 0.97). However, current smokers were more likely than never smokers to develop bacterial pneumonia (RH = 1.57; 95% CI 1.14-2.15, p = 0.006), oral candidiasis (RH = 1.37; 95% CI 1.16-1.62: p = 0.0002), and BIDS dementia complex (RH = 1.80; 95% CI 1.11-2.90; p = 0.02), In addition, current smokers were less likely to develop Kaposi's sarcoma (RH = 0.58; 95% CI 0.39-0.88; p = 0.01) and several other non-respiratory tract diseases, If confirmed by other studies, these findings have important clinical implications.
引用
收藏
页码:374 / 383
页数:10
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