Effects of Smoking on Non-AIDS-Related Morbidity in HIV-Infected Patients

Shirley, Daniel; Kaner, Robert J.; Glesby, Marshall J.

doi:10.1093/cid/cit207

Cited by 67 publications

(64 citation statements)

References 102 publications

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“…7,9,48,49 Studies show an increase in COPD in this population, and as in the general population, this number is likely under-reported due to lack of screening and in HIV infected patients, a historical emphasis of HIV treatment as a priority over testing and management of chronic diseases. 2,5,50 In our pilot study of a COPD screening strategy in an HIV clinic, we found that 12% of those completing spirometry had evidence of previously undiagnosed obstructive lung disease, revealing clear deficits in the recognition of pulmonary disease in this population.…”

Section: Discussionmentioning

confidence: 90%

Screening for Chronic Obstructive Pulmonary Disease (COPD) in an Urban HIV Clinic: A Pilot Study

Shirley¹,

Kaner

Glesby

2015

AIDS Patient Care and STDs

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Increased smoking and a detrimental response to tobacco smoke in the lungs of HIV/AIDS patients result in an increased risk for COPD. We aimed to determine the predictive value of a COPD screening strategy validated in the general population and to identify HIV-related factors associated with decreased lung function. Subjects at least 35 years of age at an HIV clinic in New York City completed a COPD screening questionnaire and peak flow measurement. Those with abnormal results and a random one-third of normal screens had spirometry. 235 individuals were included and 89 completed spirometry. Eleven (12%) had undiagnosed airway obstruction and 5 had COPD. A combination of a positive questionnaire and abnormal peak flow yielded a sensitivity of 20% (specificity 93%) for detection of COPD. Peak flow alone had a sensitivity of 80% (specificity 80%). Abnormal peak flow was associated with an AIDS diagnosis ( p = 0.04), lower nadir ( p = 0.001), and current CD4 counts ( p = 0.001). Nadir CD4 remained associated in multivariate analysis (p = 0.05). Decreased FEV1 ( < 80% predicted) was associated with lower CD4 count nadir ( p = 0.04) and detectable current HIV viral load ( p = 0.01) in multivariate analysis. Questionnaire and peak flow together had low sensitivity, but abnormal peak flow shows potential as a screening tool for COPD in HIV/AIDS. These data suggest that lung function may be influenced by HIV-related factors.

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Section: Discussionmentioning

confidence: 90%

Screening for Chronic Obstructive Pulmonary Disease (COPD) in an Urban HIV Clinic: A Pilot Study

Shirley¹,

Kaner

Glesby

2015

AIDS Patient Care and STDs

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“…Smoking also appears to have a compounding effect on chronic systemic inflammation associated with HIV, and this exaggerated inflammation may increase the risk for chronic illnesses such as chronic obstructive pulmonary disease, atherosclerotic disease, and others. 27 …”

Section: Smoking-related Morbidity and Mortality Among Plwhamentioning

confidence: 99%

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

Ledgerwood

Yskes

2016

NICTOB

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Introduction: People living with HIV/AIDS (PLWHA) are more likely to smoke cigarettes than are individuals in the general population. The health implications of tobacco use are substantially more dire among PLWHA than among otherwise healthy smokers, including higher rates of various cancers, cardiovascular disease, inflammation, and lung infections. Efficacious behavioral and medication treatments for treating nicotine dependence have rarely been investigated in PLWHA. Methods: We present a review of studies examining the efficacy of smoking cessation interventions. Results and Conclusions:The literature reveals some limited evidence for the efficacy of behavioral interventions. However, the research literature on these interventions is sparse and the efficacy findings are mixed. Studies exploring the use of mobile technologies for reducing treatment barriers are becoming more prevalent. Few published trials have directly examined the efficacy of pharmacological smoking cessation interventions among PLWHA. Specific gaps in the treatment literature are discussed in detail, and a strategy is presented for developing a greater understanding of factors that contribute to the efficacy of smoking cessation among PLWHA. Implications: This paper provides the most comprehensive review to date on smoking cessation intervention research conducted with PLWHA. It also discusses specific gaps in the literature that should be a priority for future research.

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“…Youth are also characterized by higher rates of sexual risk behaviors (Eaton et al, 2012) and poor medication adherence (Tanney et al, 2010); exacerbation of these risk behaviors by substance use has implications for HIV prevention and treatment outcome. In addition, tobacco use is higher among individuals with HIV than in the general population (Webb et al, 2007), and is an important contributor to non-AIDS-defining as well as AIDS-defining illness and mortality in this population (Helleberg et al, 2013; Shirley et al, 2013). Accurate assessment of substance use among youth with HIV has great importance for research on HIV treatment and outcomes as well as for clinical care.…”

Section: Introductionmentioning

confidence: 99%

Concordance between self-reported substance use and toxicology among HIV-infected and uninfected at risk youth

Nichols

Lowe

Zhang

et al. 2014

Drug and Alcohol Dependence

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Background Substance use by youth living with HIV (YLWH) is a concern, given potential interactions with virus-associated immune suppression and adverse effects on risk behaviors, neurocognition, and adherence. Self-report substance use measures provide efficient cost-effective assessments. Analyses describe self-reported substance use among YLWH and examine agreement with toxicology assays. Methods Seventy-eight youth age 18–24 years (87% male, 71% African–American) with behaviorally acquired HIV-1 infection and 55 uninfected youth completed the Alcohol, Smoking, and Substance Involvement Screening Test to assess drug use frequency, including tobacco, marijuana, cocaine, and alcohol, over the prior three months. Elisa-based toxicology assays were used to detect 27 substances in plasma. Chi-square tests compared substance use between YLWH and uninfected youth; Kappa statistics compared agreement between self-report and toxicology. Results YLWH reported marijuana (49%), tobacco (56%), and alcohol (87%) use, with 20%, 28% and 3% reporting daily use of each substance, respectively; other substance use was uncommon. Uninfected youth reported less tobacco use but otherwise similar substance use. All youth who reported daily use of marijuana or tobacco had positive plasma toxicology results, while concordance decreased with less frequent self-reported use. Among youth reporting no substance use, few tested positive (4% YLWH, 2% uninfected youth for cannabis; 8%YLWH for tobacco). Conclusions Youth report high rates of marijuana, tobacco, and alcohol use. Concordance between self-report and toxicology for marijuana and tobacco use, particularly for daily users, supports self-report as a valid indicator of substance use in research studies of youth with or without HIV-1 infection.

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Effects of Smoking on Non-AIDS-Related Morbidity in HIV-Infected Patients

Cited by 67 publications

References 102 publications

Screening for Chronic Obstructive Pulmonary Disease (COPD) in an Urban HIV Clinic: A Pilot Study

Screening for Chronic Obstructive Pulmonary Disease (COPD) in an Urban HIV Clinic: A Pilot Study

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

Concordance between self-reported substance use and toxicology among HIV-infected and uninfected at risk youth

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