Brief Report: Rate of Nicotine Metabolism and Tobacco Use Among Persons With HIV: Implications for Treatment and Research

Schnoll, Robert A.; Thompson, Morgan; Serrano, Katrina J.; Leone, Frank T.; Metzger, David; Frank, Ian; Gross, Robert; Mounzer, Karam; Tyndale, Rachel F.; Weisbrot, Jessica; Meline, Miles; Collman, Ronald G.; Ashare, Rebecca L.

doi:10.1097/qai.0000000000001895

Cited by 13 publications

(18 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Ashare et al found that the mean NMR levels in PWH was 0.47, compared with 0.34 in PWOH; Schnoll et al found that PWH not on efavirenzcontaining ART had an NMR of 0.44. 12,13 Our finding of similar NMR before and after HIV seroconversion-at levels consistent with other studies of PWH-may suggest that a higher NMR reported in other studies of PWH reflects a higher baseline CYP2A6 activity in persons who acquire HIV, rather than a direct effect of HIV infection itself. These findings may suggest that higher CYP2A6 activity may be in the causal pathway for HIV acquisition, while ART may further increase the NMR.…”

Section: Discussionsupporting

confidence: 89%

Brief Report: HIV Infection Does Not Explain Higher Nicotine Metabolism in People Living With HIV

Arens

Bilker

Han

et al. 2022

JAIDS Journal of Acquired Immune Deficiency Syndromes

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 89%

Brief Report: HIV Infection Does Not Explain Higher Nicotine Metabolism in People Living With HIV

Arens

Bilker

Han

et al. 2022

JAIDS Journal of Acquired Immune Deficiency Syndromes

Self Cite

View full text Add to dashboard Cite

show abstract

“…In our study, we found that among ever smokers about a 25% of PLWH and more than half the general population had stopped smoking at the time of data collection. This low quitting rate among PLWH may be related to many factors, such as a high level of nicotine dependence and/or with a faster nicotine metabolism observed in PLWH [24]. In our study, we could not directly compare the degree of nicotine dependence between PLWH and the general population, because this information was not collected in the ISTAT survey.…”

Section: Discussionmentioning

confidence: 89%

Smoking habits in HIV-infected people compared with the general population in Italy: a cross-sectional study

et al. 2020

View full text Add to dashboard Cite

Background: Tobacco use is a leading cause of preventable diseases and death for all individuals, even more so for people living with HIV (PLWH), due to their status of chronic inflammation. To date, in Italy no study was performed to compare smoking habits in PLWH and the general population. We aimed to investigate smoking habits in PLWH, as compared to the general population. Methods: Multi-center cross-sectional study. Smoking habits were compared between PLWH and the general population. PLWH were enrolled in the STOPSHIV Study. The comparison group from the general population was derived from a survey performed by the National Statistics Institute (ISTAT), with a stratified random sampling procedure matching 2:1 general population subjects with PLWH by age class, sex, and macro-area of residence. Results: The total sample consisted of 1087 PLWH (age 47.9 ± 10.8 years, male 73.5%) and 2218 comparable subjects from the general population. Prevalence of current smokers was 51.6% vs 25.9% (p < 0.001); quitting smoking rate was 27.1% vs. 50.1% (p < 0.001) and the mean number of cigarettes smoked per day was 15.8 vs. 11.9 (p < 0.001), respectively for PLWH and the general population. Smoking and heavy smoking rates amongst PLWH were significantly higher even in subjects who reported diabetes, hypertension and extreme obesity (p < 0.001). Logistic regressions showed that PLWH were more likely current smokers (adjusted Odds Ratio, aOR = 3.11; 95% Confidence Interval (CI) =2.62-3.71; p < 0.001) and heavy smokers (> 20 cigarettes per day) (aOR = 4.84; 95% CI = 3.74-6.27; p < 0.001). PLWH were less likely to have quitted smoking (aOR = 0.36; 95% CI = 0.29-0.46; p < 0.001). Conclusion: HIV-infected patients showed a higher rate of current smokers, a larger number of cigarettes smoked and a lower quitting rate than the general population. Our findings emphasize the need for smoking cessation strategies targeting HIV persons.

show abstract

“…For instance, use of the antiretroviral drug efavirenz, a CYP2A6 substrate, has been associated with greater NMR. 15 We investigated whether viral suppression on effective ART resulted in increased NMR compared with periods of uncontrolled viremia off-ART in a cohort of smokers with HIV. In addition, we hypothesized that efavirenz-containing regimens would be associated with the greatest increases in NMR compared with other ART regimens.…”

Section: Introductionmentioning

confidence: 99%

“…For instance, use of the antiretroviral drug efavirenz, a CYP2A6 substrate, has been associated with greater NMR. 15…”

Section: Introductionmentioning

confidence: 99%

Brief Report: Nicotine Metabolism Ratio Increases in HIV-Positive Smokers on Effective Antiretroviral Therapy: A Cohort Study

Bien-Gund

Bilker

Schnoll

et al. 2022

JAIDS Journal of Acquired Immune Deficiency Syndromes

Self Cite

View full text Add to dashboard Cite

Background: People with HIV (PWH) smoke tobacco at much higher rates than the general population. Previous research has shown that PWH have faster nicotine metabolism than HIVuninfected individuals, which may underlie this disparity, but the cause is unknown. We investigated whether higher nicotine metabolite ratio (NMR; 3-hydroxycotinine:cotinine), a validated biomarker of nicotine metabolism through CYP2A6, was associated with antiretroviral use among HIV-infected smokers. Methods:We conducted a retrospective cohort study of HIVpositive smokers in the University of Pennsylvania Center for AIDS Research cohort. We compared the NMR before viral suppression (.10,000 copies/mL) and after viral suppression on antiretroviral therapy (,200 copies/mL). We used mixed-effects linear regression to analyze the change in NMR after viral suppression and assessed for effect modification by efavirenz use.Results: Eighty-nine individuals were included in the study. We observed effect modification by efavirenz use (interaction term for efavirenz use, P , 0.001). Among those on nonefavirenz regimens, the mean NMR increased by 0.14 (95% confidence interval: 0.05 to 0.23, P = 0.002). Among those on efavirenz-containing regimens, the mean NMR increased by 0.53 (95% confidence interval: 0.39-0.66, P , 0.001). Conclusions:We observed a clinically and statistically significant increase in NMR after viral suppression among smokers with HIV, which more than doubled among those on efavirenz-based regimens. Higher NMR among HIV-positive smokers on antiretroviral therapy may help explain the higher rates of tobacco use and lower quit rates among PWH in care. These findings suggest that regimen choice and other modifiable factors may be targets for future attempts to increase success rates for tobacco cessation among PWH.

show abstract

Brief Report: Rate of Nicotine Metabolism and Tobacco Use Among Persons With HIV: Implications for Treatment and Research

Cited by 13 publications

References 40 publications

Brief Report: HIV Infection Does Not Explain Higher Nicotine Metabolism in People Living With HIV

Brief Report: HIV Infection Does Not Explain Higher Nicotine Metabolism in People Living With HIV

Smoking habits in HIV-infected people compared with the general population in Italy: a cross-sectional study

Brief Report: Nicotine Metabolism Ratio Increases in HIV-Positive Smokers on Effective Antiretroviral Therapy: A Cohort Study

Contact Info

Product

Resources

About