HIV patients face new killer

Infected People Who Smoke At Heightened Risk Of Mortality

Bangalore: Tobacco-related diseases and the 2.5 million HIVinfected persons are the two biggest health challenges for India today. Now, studies show that HIV-infected persons who smoke may be at a higher risk of getting several infectious diseases, including malignancies and cardiovascular problems, which increase chances of morbidity (indicative of disease) and mortality (death).
    Smoking cessation among HIV-infected persons is difficult due to psychosocial issues like depression and drug abuse. There have also been no special stop-smoking measures for such patients. Recent research by the Tuberculosis Research Institute of the Indian Council of Medical Research (ICMR) and Brown University, USA, shows that HIV-infected individuals who smoke could be at a greater risk of developing TB and subsequently suffer higher morbidity and mortality than those who don’t smoke.
    The study highlights that public health measures like banning smoking in public places and raising tobacco tax aren’t enough. More research, including clinical trials to assess the efficacy of smoking cessation in HIV+, is required.
FEW FEMALE PATIENTS HAVE EVER SMOKED
A survey among patients at TN’s Tuberculosis Research Centre showed that history of smoking (current or past) among males (HIV without TB) was 66% whereas among females only one (0.4%) had a history of smoking. Among 138 men with HIV and TB, the history of smoking was 76% whereas no female gave a history of smoking. No studies have been conducted yet in India on higher smoking rates among the HIV+ individuals compared to uninfected TB patients, but this pilot study confirms that mortality is higher among infected smokers. There is a need for larger studies to estimate smoking rates among them in different geographical areas and among various socioeconomic groups.
WHAT ARE THE RISKS?
    Tobacco use ups the risk of pulmonary diseases & communityacquired pneumonia, two respiratory infections with high prevalence and morbidity risks
    Even in the era of highly active anti-retroviral therapy (ART), HIV-infected individuals are at increased risk of respiratory symptoms such as cough, sputum production, wheezing and dyspnoea (difficulty in breathing) even prior to onset of AIDS-related pulmonary complications
    Chest medicine and HIV medication expert, Wockhardt Hospital, Dr K Satish said, “HIV-infected people who continue to smoke develop pneumonia, cholesterol levels go up & morbidity risk increases.”
STUDY FINDINGS
According to the recently published study ‘HIV and Smoking’:
    Smoking alters immunological mechanism and suppresses host defences in the alveolar environment. HIV+ smokers have also shown poorer response to ART and face higher risk of death
    Smoking might be independently associated with acquiring HIV infection but not to progression to AIDS
    Prevalence of HIV higher among male smokers (0.43%) than females (0.29%)