title: Smoking and projected cardiovascular risk in an HIV-positive Asian regional cohort.
abstract: The aim of the study was to assess the prevalence and characteristics associated with current smoking in an Asian HIV-positive cohort, to calculate the predictive risks of cardiovascular disease (CVD), coronary heart disease (CHD) and myocardial infarction (MI), and to identify the impact that simulated interventions may have.
  
  
  
  Logistic regression analysis was used to distinguish associated current smoking characteristics. Five-year predictive risks of CVD, CHD and MI and the impact of simulated interventions were calculated utilizing the Data Collection on Adverse Effects of Anti-HIV Drugs Study (D:A:D) algorithm.
  
  
  
  Smoking status data were collected from 4274 participants and 1496 of these had sufficient data for simulated intervention calculations. Current smoking prevalence in these two groups was similar (23.2% vs. 19.9%, respectively). Characteristics associated with current smoking included age > 50 years compared with 30-39 years [odds ratio (OR) 0.65; 95% confidence interval (CI) 0.51-0.83], HIV exposure through injecting drug use compared with heterosexual exposure (OR 3.03; 95% CI 2.25-4.07), and receiving antiretroviral therapy (ART) at study sites in Singapore, South Korea, Malaysia, Japan and Vietnam in comparison to Thailand (all OR > 2). Women were less likely to smoke than men (OR 0.11; 95% CI 0.08-0.14). In simulated interventions, smoking cessation demonstrated the greatest impact in reducing CVD and CHD risk and closely approximated the impact of switching from abacavir to an alternate antiretroviral in the reduction of 5-year MI risk.
  
  
  
  Multiple interventions could reduce CVD, CHD and MI risk in Asian HIV-positive patients, with smoking cessation potentially being the most influential.
authors.affiliation: HIVNAT/Thai Red Cross AIDS Research Center, Bangkok, Thailand.
authors.forename: T C
authors.initials: TC
authors.lastname: Do
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Boettiger
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Law
authors.affiliation: Institute of Infectious Diseases, Pune, India.
authors.forename: S
authors.initials: S
authors.lastname: Pujari
authors.affiliation: Beijing Ditan Hospital, Capital Medical University, Beijing, China.
authors.forename: F
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Research Institute for Health Sciences, Chiang Mai, Thailand.
authors.forename: R
authors.initials: R
authors.lastname: Chaiwarith
authors.affiliation: Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: S
authors.initials: S
authors.lastname: Kiertiburanakul
authors.affiliation: Queen Elizabeth Hospital, Hong Kong, China.
authors.forename: M P
authors.initials: MP
authors.lastname: Lee
authors.affiliation: Research Institute for Tropical Medicine, Manila, Philippines.
authors.forename: R
authors.initials: R
authors.lastname: Ditangco
authors.affiliation: Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: W W
authors.initials: WW
authors.lastname: Wong
authors.affiliation: National Hospital for Tropical Diseases, Hanoi, Vietnam.
authors.forename: K V
authors.initials: KV
authors.lastname: Nguyen
authors.affiliation: Faculty of Medicine Udayana University & Sanglah Hospital, Bali, Indonesia.
authors.forename: T P
authors.initials: TP
authors.lastname: Merati
authors.affiliation: Bach Mai Hospital, Hanoi, Vietnam.
authors.forename: T T
authors.initials: TT
authors.lastname: Pham
authors.affiliation: University Malaya Medical Center, Kuala Lumpur, Malaysia.
authors.forename: A
authors.initials: A
authors.lastname: Kamarulzaman
authors.affiliation: AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Oka
authors.affiliation: Working Group on AIDS Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
authors.forename: E
authors.initials: E
authors.lastname: Yunihastuti
authors.affiliation: Chennai Antiviral Research and Treatment Clinical Research Site (CART CRS), YRGCARE Medical Centre, VHS, Chennai, India.
authors.forename: N
authors.initials: N
authors.lastname: Kumarasamy
authors.affiliation: Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand.
authors.forename: P
authors.initials: P
authors.lastname: Kantipong
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: J Y
authors.initials: JY
authors.lastname: Choi
authors.affiliation: Tan Tock Seng Hospital, Singapore.
authors.forename: O T
authors.initials: OT
authors.lastname: Ng
authors.affiliation: TREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand.
authors.forename: N
authors.initials: N
authors.lastname: Durier
authors.affiliation: HIVNAT/Thai Red Cross AIDS Research Center, Bangkok, Thailand.|Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: K
authors.initials: K
authors.lastname: Ruxrungtham
mesh_terms: D000328:Adult; D001208:Asia / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology*
keywords: Asia; HIV; cardiovascular risk; smoking prevalence