Cigarette smoking is an independent predictor of nonadherence in HIV-infected individuals receiving highly active antiretroviral therapy

Abstract

Current treatment guidelines for the management of HIV-infected individuals emphasize the importance of excellent adherence to antiretroviral medications. We conducted a prospective 24-week study of adherence to lopinavir/ritonavir in a group of 64 subjects using the Medication Event Monitoring System (MEMS). A range of demographic and clinical information, including cigarette smoking status, was collected from each participant. The overall mean adherence rate of the study cohort was 72.8% (SD = 22.2%). Current smokers took 63.5% (SD = 22.1) of prescribed doses, compared with 84.8% (SD = 15.8%) in nonsmokers (p<.001). We found no difference in adherence rates between ex-smokers and subjects who had never smoked. In a multiple linear regression model, factors independently associated with lower adherence rates included current smoking (p = .001), lower CD4+ lymphocyte count at enrollment (p = .04), and lower educational attainment (p = .04). Depression and history of illicit substance use were not associated with nonadherence. In our study cohort, current cigarette smoking was an important and significant marker of inferior adherence to antiretroviral medication.

Smoking Cessation for People Living With HIV/AIDS: A Literature Review and Synthesis

“…[19][20][21][22] Smokers are also more likely to progress to an AIDS diagnosis, 23 have poorer response to ART, 12 and are more likely to be nonadherent to ART. 24 Importantly, longer duration of abstinence from smoking substantially reduces HIV symptom burden. 25 This finding is increasingly important as HIV shifts from being a largely deadly disease to a chronic illness that can be managed with increasing efficacy.…”

Hydroxychloroquine and smoking in patients with cutaneous lupus erythematosus

“…3 In a study of HIV-positive men and women (n = 64), current cigarette smoking, lower CD4 counts and lower educational status emerged as independent predictors of poorer adherence among patients on HAART. 69 …”

HIV Infection in the Etiology of Lung Cancer: Confounding, Causality, and Consequences

“…Compared with the 20% prevalence of smoking in the United States general population (1), the prevalence of smoking has consistently been reported as higher in HIV-infected populations (Table 1) (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). In numerous studies of smoking prevalence conducted in varied risk groups from the United States and Europe, more than two thirds of HIV-infected persons have reported being a regular smoker at some time in their life.…”