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

Ledgerwood, David M.; Yskes, Russell

doi:10.1093/ntr/ntw126

Cited by 84 publications

(61 citation statements)

References 68 publications

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“…Whereas no differences in quit outcomes were found for the studies that examined data by gender, overall quit rates were generally very low with the large majority of men and women being unable to abstain from smoking over time. In general, there is a need for more efficacious and effective smoking treatments for PLWH 72-75 . More data by gender on smoking variables would help to inform efforts to develop smoking interventions that improve quit outcomes for both men and women.…”

Section: Discussionmentioning

confidence: 99%

Sex Differences in Tobacco Use Among Persons Living With HIV/AIDS: A Systematic Review and Meta-Analysis

Weinberger

Smith

Funk

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background Persons living with HIV/AIDS (PLWH) smoke at higher rates than other adults and experience HIV-related and non-HIV-related adverse smoking consequences. The current study conducted a systematic review to synthesize current knowledge about gender differences in smoking behaviors among PLWH. Methods Over three thousand abstracts from MEDLINE were reviewed and seventy-nine publications met all of the review inclusion criteria (i.e., reported data on smoking behaviors for PLWH by gender). Sufficient data were available to conduct a meta-analysis for one smoking variable: current smoking prevalence. Results Across studies (n=51), the meta-analytic prevalence of current smoking among female PLWH was 36.3% (95% CI=28.0%-45.4%) and male PLWH was 50.3% (95% CI=44.4%-56.2%; meta-analytic OR=1.78, 95% CI=1.29-2.45). When analyses were repeated just on United States (U.S.) studies (n=23), the prevalence of current smoking was not significantly different for female PLWH (55.1%, 95% CI=47.6%-62.5%) compared to male PLWH (55.5%, 95% CI=48.2%-62.5%; meta-analytic OR=1.04, 95% CI=0.86-1.26). Few studies reported data by gender for other smoking variables (e.g., quit attempts, non-cigarette tobacco product use) and results for many variables were mixed. Discussion Unlike the general U.S. population, there was no difference in smoking prevalence for female versus male PLWH (both >50%) indicating that HIV infection status was associated with a greater relative increase in smoking for women than men. More research is needed in all areas of smoking behavior of PLWH to understand similarities and differences by gender in order to provide the best interventions to reduce the high smoking prevalence for all genders.

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Section: Discussionmentioning

confidence: 99%

Sex Differences in Tobacco Use Among Persons Living With HIV/AIDS: A Systematic Review and Meta-Analysis

Weinberger

Smith

Funk

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…Smoking cessation is a priority in HIV. 113 It may be necessary to tailor current approaches to HIV-infected populations who have been shown to have unique barriers to contemplating cessation or quitting smoking, including alcohol use, 114 having a detectable HIV RNA, 115 lower nicotine dependency level, 116 and older age. 116 In a randomized study of 12 weeks of varenicline alone versus in combination with text messaging and a cell phone-delivered adherence intervention, smoking abstinence was higher in the intervention group.…”

Section: Management and Prevention Of Ischemic Heart Disease In Hivmentioning

confidence: 99%

Epidemiology of ischemic heart disease in HIV

Triant

Grinspoon

2017

Current Opinion in HIV and AIDS

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Purpose of review The purpose of this review is to summarize and synthesize recent data on the risk of ischemic heart disease (IHD) in HIV-infected individuals. Recent findings Recent studies in the field demonstrate an increasing impact of cardiovascular disease (CVD) on morbidity and mortality in HIV relative to AIDS-related diagnoses. Studies continue to support an approximately 1.5 to 2-fold increased risk of IHD conferred by HIV, with specific risk varying by gender and virologic/immunologic status. Risk factors include both traditional CVD risk factors and novel, HIV-specific factors including inflammation and immune activation. Specific antiretroviral therapy (ART) drugs may increase CVD risk, yet the net effect of ART with viral suppression is beneficial with regards to CVD risk. Management of cardiovascular risk and prevention of CVD is complex, because current general population strategies target traditional CVD risk factors only. Extensive investigation is being directed at developing tailored CVD risk prediction algorithms and interventions to reduce CVD risk to HIV. Summary Increased IHD risk is a significant clinical and public health challenge in HIV. The development and application of HIV-specific interventions to manage CVD risk factors and reduce CVD risk will improve the long-term health of this aging population.

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“…[43] Given the prevalence and impact of COPD in HIV, these findings support increased attention to smoking cessation in PLHW to reduce COPD incidence and attenuate pulmonary function decline, and there are limited studies addressing cessation interventions in PLWH. [55,56] Our findings also highlight the importance of interventions to diagnose and manage COPD in PLWH to prevent decline in health. Finally, markers of COPD may have a role in mortality prediction models in HIV, such as the VACS Index, though this will require further study.…”

Section: Discussionmentioning

confidence: 65%

Markers of chronic obstructive pulmonary disease are associated with mortality in people living with HIV

Triplette

Justice

Attia

et al. 2018

Aids

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Objective. Aging people living with HIV (PLWH) face an increased burden of comorbidities, including chronic obstructive pulmonary disease (COPD). The impact of COPD on mortality in HIV remains unclear. We examined associations between markers of COPD and mortality among PLWH and uninfected subjects.Design. Longitudinal analysis of the Examinations of HIV-Associated Lung Emphysema (EXHALE) cohort study.Methods. EXHALE includes 196 PLWH and 165 uninfected smoking-matched subjects who underwent pulmonary function testing and CT scans to define COPD and were followed. We determined associations between markers of COPD with mortality using multivariable Cox regression models, adjusted for smoking and the VACS Index, a validated predictor of mortality in HIV.Results. Median follow-up time was 6.9 years; the mortality rate was 2.7 per 100-person-years among PLWH and 1.7 per 100-person-years among uninfected subjects (p=0.11). The VACS Index was associated with mortality in both PLWH and uninfected subjects. In multivariable models, pulmonary function and CT characteristics defining COPD were associated with mortality in PLWH: those with airflow obstruction (FEV1/FVC<0.7) had 3.1 times the risk of death (HR 3.1 [95% CI 1.4-7.1]), compared to those without; those with emphysema (>10% burden) had 2.4 times the risk of death (HR 2.4 [95% CI 1.1-5.5]) compared to those with ≤10% emphysema. In uninfected subjects, pulmonary variables were not significantly associated with mortality, which may reflect fewer deaths limiting power.Conclusions. Markers of COPD were associated with greater mortality in PWLH, independent of the VACS Index. COPD is likely an important contributor to mortality in contemporary PLWH.

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

Cited by 84 publications

References 68 publications

Sex Differences in Tobacco Use Among Persons Living With HIV/AIDS: A Systematic Review and Meta-Analysis

Sex Differences in Tobacco Use Among Persons Living With HIV/AIDS: A Systematic Review and Meta-Analysis

Epidemiology of ischemic heart disease in HIV

Markers of chronic obstructive pulmonary disease are associated with mortality in people living with HIV

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