AIDS and Behavior 2017 (in press). [doi: 10.1007/s10461-017-1928-x]
Theresa M. Winhusen, PhD (University of Cincinnati, OV Node), Daniel J. Feaster, PhD (University of Miami, FNA Node), Rui Duan (University of Miami, FNA Node), Jennifer L. Brown, PhD (University of Cincinnati, OV Node), Eric S. Daar, MD (University of California, Los Angeles), Raul N. Mandler, MD (NIDA Center for the Clincial Trials Network), Lisa R. Metsch, PhD (Columbia University, FNA Node).
Cigarette smoking is prevalent in people living with HIV/AIDS (PLHIV) who abuse alcohol and/or illicit substances. This study evaluated whether smoking is predictive of virologic non-suppression (>200 copies/mL) and low CD4 count (<200 cells/mm3) during 1-year follow-up in medically hospitalized, substance-using PLHIV recruited for a multi-site trial (CTN-0049, Project HOPE: Hospital Visit as Opportunity for Prevention and Engagement for HIV-Infected Drug Users). Smoking status was assessed with the Heaviness of Smoking Index (HSI).
Analyses revealed that, controlling for baseline differences and adherence to antiretroviral therapy, non-smokers (n=237), compared to smokers scoring in the medium-to-high range on the HSI (n=386), were significantly more likely to achieve viral suppression. There was a significant smoking-by-time interaction for CD4 cell count, with smokers less likely to have low CD4 count at baseline and 6-month follow-up, but more likely to have low CD4 count at 12-month follow-up.
Conclusions: The results of this exploratory analysis suggest that smoking may play a role in immunnologic response in HIV-infected substance users. Future research to replicate this finding and to delineate the potential mechanisms by which smoking may affect HIV progression seems warranted. (Article (Peer-Reviewed), PDF, English, 2017)
Keywords: CTN platform/ancillary study | Heaviness of Smoking Index (HSI) | HIV/AIDS | Smoking | AIDS and Behavior (journal)
Document No: 1284.
Submitted by Jack Blaine, MD, CCTN, NIDA 10/18/2017.