Effect of smoking on the clinical progression of HIV-1 infection.
Cigarette smoking as a risk factor in progression of HIV-1 disease was investigated in the Multicenter AIDS Cohort Study of homosexual men. Longitudinal data for T-cell subsets, HIV-related clinical symptoms, smoking behavior, and AIDS medication use were collected semiannually from 2,499 HIV-1-seropositive men for up to 9 years. Survival methods, including Kaplan-Meier analysis and multivariate Cox regression models, were used to assess the effect of cigarette smoking on development of Pneumocystis carinii pneumonia (PCP), AIDS, death, and self-reported oral thrush. After adjustment for CD4+ lymphocyte count and use of antiretroviral and anti-PCP medications, smoking was not significantly associated with progression to PCP, AIDS, or death in either the HIV-seroprevalent or-seroincident cohort members. Among men who had baseline CD4+ cell counts > 200/microliter, smoking was associated with a 40% increase in the hazard of oral thrush (p < or = 0.01). These data indicate that cigarette smoking does not have a major effect on the progression of HIV-1 infection to AIDS or death but may affect the incidence of oral thrush.
Galai
N
N
Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, MD 21205, USA.
Park
L P
LP
Wesch
J
J
Visscher
B
B
Riddler
S
S
Margolick
J B
JB
D002180:Candidiasis, Oral / Q000209:etiology; D015331:Cohort Studies; D018450:Disease Progression; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000209:etiology*; D015528:HIV Seroprevalence; D015497:HIV-1; D015438:Health Behavior; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D008297:Male; D011020:Pneumonia, Pneumocystis / Q000453:epidemiology / Q000209:etiology; D016016:Proportional Hazards Models; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D016019:Survival Analysis