Effects of cigarette smoking and nicotine dependence on adherence to antiretroviral therapy among HIV-positive patients in Vietnam

Nguyen, Nhung; Tran, Bach Xuan; Hwang, Lu Yu; Markham, Christine; Swartz, Michael D.; Vidrine, Jennifer Irvin; Phan, Huong Thu Thi; Latkin, Carl A.; Vidrine, Damon J.

doi:10.1080/09540121.2015.1090535

Cited by 24 publications

(22 citation statements)

References 19 publications

(25 reference statements)

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“…However, in multivariable models after adjusting for covariates, no significant associations were found between current smoking and imperfect ART adherence. Others (21, 22) have examined medication adherence and smoking in PLWH, and also have not found an association with ART adherence. It is possible that smoking and imperfect ART adherence share similar risk factors and, perhaps, smoking may be acting as a surrogate marker for these other factors.…”

Section: Discussionmentioning

confidence: 99%

“…While some studies have shown that smokers have a higher prevalence of detectable HIV viral load (14, 18–20), overall, research in this area has provided mixed results with regard to the association between cigarette smoking and ART adherence. For example, two studies found no association between smoking status and ART adherence (21, 22), while another found that nicotine dependence (measured by the Fagerstrom Test for Nicotine Dependence [FTND]) was significantly related to suboptimal adherence (23). Thus, there remain open questions about the associations between smoking and HIV medication adherence.…”

Section: Introductionmentioning

confidence: 99%

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Cigarette Smoking and Antiretroviral Therapy (ART) Adherence in a Sample of Heavy Drinking HIV-Infected Men Who Have Sex with Men (MSM)

et al. 2016

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Cigarette smoking and heavy alcohol use is prevalent among HIV-infected men who sex with men (MSM) and have been linked to imperfect antiretroviral therapy (ART) adherence. Our study examined the correlates of smoking and whether smoking was independently associated with imperfect adherence in heavy-drinking HIV-infected MSM. Of the 185 participants, approximately half (n = 91, 49.2%) reported having smoked cigarettes in the past 30 days. Current smokers were more likely to have reported imperfect adherence compared to non-smokers (37.4.2% vs. 22.3%, p < 0.05). In multivariable regression analyses, only lower education was significantly associated with imperfect adherence. This study demonstrated that the greatest risk factor for smoking and imperfect ART adherence was low socioeconomic status, in which MSM of color were over-represented. As the first study to examine smoking and ART adherence in this population, our study has the potential to inform the clinical care provided to heavy-drinking MSM.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cigarette Smoking and Antiretroviral Therapy (ART) Adherence in a Sample of Heavy Drinking HIV-Infected Men Who Have Sex with Men (MSM)

et al. 2016

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“…This increased susceptibility has been mainly attributed to biochemical mechanisms including the immunosuppressive effects of smoking and its negative impact on immune and virological response even when on ART 13 . Behavioural mechanisms have also been suggested—for example, an association between smoking and non-adherence to antiretroviral therapy 14, 15…”

Section: Introductionmentioning

confidence: 99%

Tobacco use among people living with HIV: analysis of data from Demographic and Health Surveys from 28 low-income and middle-income countries

Mdege

Shah

Ayo‐Yusuf

et al. 2017

The Lancet Global Health

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SummaryBackgroundTobacco use among people living with HIV results in excess morbidity and mortality. However, very little is known about the extent of tobacco use among people living with HIV in low-income and middle-income countries (LMICs). We assessed the prevalence of tobacco use among people living with HIV in LMICs.MethodsWe used Demographic and Health Survey data collected between 2003 and 2014 from 28 LMICs where both tobacco use and HIV test data were made publicly available. We estimated the country-specific, regional, and overall prevalence of current tobacco use (smoked, smokeless, and any tobacco use) among 6729 HIV-positive men from 27 LMICs (aged 15–59 years) and 11 495 HIV-positive women from 28 LMICs (aged 15–49 years), and compared them with those in 193 763 HIV-negative men and 222 808 HIV-negative women, respectively. We estimated prevalence separately for males and females as a proportion, and the analysis accounted for sampling weights, clustering, and stratification in the sampling design. We computed pooled regional and overall prevalence estimates through meta-analysis with the application of a random-effects model. We computed country, regional, and overall relative prevalence ratios for tobacco smoking, smokeless tobacco use, and any tobacco use separately for males and females to study differences in prevalence rates between HIV-positive and HIV-negative individuals.FindingsThe overall prevalence among HIV-positive men was 24·4% (95% CI 21·1–27·8) for tobacco smoking, 3·4% (1·8–5·6) for smokeless tobacco use, and 27·1% (22·8–31·7) for any tobacco use. We found a higher prevalence in HIV-positive men of any tobacco use (risk ratio [RR] 1·41 [95% CI 1·26–1·57]) and tobacco smoking (1·46 [1·30–1·65]) than in HIV-negative men (both p<0·0001). The difference in smokeless tobacco use prevalence between HIV-positive and HIV-negative men was not significant (1·26 [1·00–1·58]; p=0·050). The overall prevalence among HIV-positive women was 1·3% (95% CI 0·8–1·9) for tobacco smoking, 2·1% (1·1–3·4) for smokeless tobacco use, and 3·6% (95% CI 2·3–5·2) for any tobacco use. We found a higher prevalence in HIV-positive women of any tobacco use (RR 1·36 [95% CI 1·10–1·69]; p=0·0050), tobacco smoking (1·90 [1·38–2·62]; p<0·0001), and smokeless tobacco use (1·32 [1·03–1·69]; p=0·030) than in HIV-negative women.InterpretationThe high prevalence of tobacco use in people living with HIV in LMICs mandates targeted policy, practice, and research action to promote tobacco cessation and to improve the health outcomes in this population.FundingSouth African Medical Research Council and the UK Medical Research Council.

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“…Higher pre-ART CD4 levels among females and higher CD4 recovery among females compared to males has been reported elsewhere, thought to be partially due to later male access to HIV services and poorer male ART adherence [40][41][42][43]. To the best of our knowledge, however, the potential joint effect of male gender and anti-HCV-positive status has not been previously reported.…”

Section: Discussionmentioning

confidence: 38%

“…To reduce bias, the current analysis specifically adjusted for gender differences in baseline CD4 levels but did not adjust for other gender-related behaviors such as cigarette smoking and alcohol consumption which are more prevalent among HIV-infected males than HIV-infected females [40,41], and found to be associated with poorer ART adherence [42,43]. However, we cannot explain why anti-HCV-positive males and females had higher baseline CD4 levels than the other serogroups.…”

Section: Discussionmentioning

confidence: 99%

CD4 Recovery and Survival among Adults Co-infected with HIV and Hepatitis B or C Virus, Ho Chi Minh City, Vietnam

Duong¹,

Nguyen²,

Shiraishi³

et al. 2017

ujph

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This study assessed associations between hepatitis B and C virus (HBV, HCV) and increases in CD4 count and survival among 4316 HIV-infected patients on non-tenofovir (TDF)-based antiretroviral treatment (ART) in Ho Chi Minh City, Vietnam during 2006-2010, using mixed-effects model and survival analysis. More than half of patients (52.4%) participating in the study were HBsAg-negative/anti-HCV-negative, 9.0% HBsAg positive/anti-HCV-negative, and 38.6% anti-HCV-positive. Anti-HCV-positive males had smaller increases in CD4 count during the first two years of ART, but larger increases between two and three years after ART initiation than anti-HCV-negative females (regardless of HBsAg status) and HBsAg-negative/anti-HCV-negative males. Magnitude of the differences was small. Overall mortality rate was 15 per 1000 person-years; HBsAg and anti-HCV status were not significantly associated with mortality. Co-infection with HBV (HBsAg-positive) and/or exposure to HCV (anti-HCV-positive) does not seem to have substantial effects on outcomes of patients on non-TDF-containing ART during a median follow-up of 1.72 years. It may take a longer time for assessing effects of co-infection with HBV and/or HCV on ART outcomes. Such assessments should focus on those with positive HCV RNA, instead of positive anti-HCV.

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Effects of cigarette smoking and nicotine dependence on adherence to antiretroviral therapy among HIV-positive patients in Vietnam

Cited by 24 publications

References 19 publications

Cigarette Smoking and Antiretroviral Therapy (ART) Adherence in a Sample of Heavy Drinking HIV-Infected Men Who Have Sex with Men (MSM)

Cigarette Smoking and Antiretroviral Therapy (ART) Adherence in a Sample of Heavy Drinking HIV-Infected Men Who Have Sex with Men (MSM)

Tobacco use among people living with HIV: analysis of data from Demographic and Health Surveys from 28 low-income and middle-income countries

CD4 Recovery and Survival among Adults Co-infected with HIV and Hepatitis B or C Virus, Ho Chi Minh City, Vietnam

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