Cigarette smokers who are HIV positive appear to have a higher chance of dying from smoking-related complications than from HIV, according to research published in the Journal of Infectious Diseases.
Previous research has suggested that each cigarette shortens a person’s lifespan by 11 minutes, and that smoking from the age of 17-71 years will decrease life expectancy by an average of 6 ½ years.
HIV is a serious health condition. Untreated, it can lead to AIDS, which is fatal. Once a person has HIV, it will never leave their body. HIV affects the body’s immune system, so that it can no longer fight off infections.
In 2014, around 44,073 people were diagnosed with HIV in the United States.
More than 40 percent of people with HIV are smokers, compared with 15 percent for the general population in the U.S. The number of people with HIV who smoke in the U.S. is estimated to be around 247,586. Another 20 percent of people with HIV are former smokers.
Current HIV treatments offer effective protection against the virus, so that people with the virus are living for longer, but people who have HIV remain especially susceptible to the risks of smoking.
Compared with other smokers, they are more likely to experience:
- White mouth sores
- Bacterial pneumonia
- Pneumocystis pneumonia, a dangerous lung infection
- Chronic obstructive pulmonary disease (COPD)
- Heart disease and stroke
- Lung cancer and other types of cancer.
Researchers from Massachusetts General Hospital and Harvard Medical School in Boston, MA, projected the effects of smoking and HIV on life expectancy.
Using a computer simulation of HIV disease and treatment, the authors calculated the life expectancy of people with HIV, based on whether or not they smoked.
- Over 1.2 million people live with HIV in the U.S.
- From 2005 to 2014, annual diagnoses fell by 19 percent
- 81 percent of HIV patients are men.
In the U.S., it is common for people with HIV to abandon their drug treatment and care regimen. The current study factored this into the projections, making the results particularly relevant for U.S. patients and health providers.
Findings showed that in people with HIV who follow their treatment correctly, smoking decreases their life expectancy by about twice as much as HIV does.
For men with HIV, the loss of life expectancy for HIV and for smoking was similar, whether or not they followed their treatment regime.
Male smokers who started HIV treatment at the age of 40 years stood to lose 6.7 years of life expectancy, and women, 6.3 years, compared with those who never smoked. Men who quit smoking and started treatment at 40 years would regain 5.7 years of life, and women, 4.6 years.
The authors conclude that people with HIV who follow their treatment but also smoke are far more likely to die of a smoking-related disease than from HIV itself.
They call for smoking cessation to be prioritized for patients with HIV. Helping them to quit smoking could significantly improve their life expectancy.
Co-author Dr. Krishna P. Reddy points out that even if a person smokes until the age of 60 years and then quits, they will have a significantly longer life expectancy than someone who does not quit.
“Now that HIV-specific medicines are so effective against the virus itself, we also need to add other interventions that could improve and extend the lives of people with HIV.”
Dr. Krishna P. Reddy
The team calls for smoking cessation to play a key role in care programs for people living with HIV. They recommend further research into the best way to help people with HIV to quit.
They also suggest investigating the health and economic benefits of quitting smoking among people living with HIV.
Dr. Keri N. Althoff, of the Johns Hopkins Bloomberg School of Public Health, comments in an accompanying editorial: “This study makes clear that we must prioritize smoking cessation among adults with HIV if we want them to have an increase in the quantity (and likely quality) of life.”