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Smoking strongly influences CV risk, multimorbidity among HIV patients
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Smoking, not HIV status, appears to be strongly related to cardiovascular risk and multimorbidity among individuals with HIV, according to recent findings.
Researchers evaluated data from 74,291 participants enrolled in either the Swiss HIV Cohort Study (n = 3,230), the population-based CoLaus Study (n = 4,569), and the primary care-based FIRE records (n = 66,492). Prevalence of comorbidity and multimorbidity were compared between participants in the Swiss HIV Cohort Study (SHCS), who represented a population with HIV, and those enrolled in the other two studies, who represented the general population.
Eligible participants from SHCS and CoLaus study were white non-injection drug users (IDUs) aged 35 years or older at baseline, with at least one follow-up visit 5 to 6 years later. Eligible FIRE participants were white non-IDUs aged 40 years or older, with at least one study visit between Jan. 1, 2009 and Dec. 31, 2011. The researchers collected data on relevant clinical events, including CV disease, stroke, diabetes mellitus, hypertension, kidney insufficiency and liver events. Cumulative endpoints for the three cohorts were determined through the end of 2011. Using logistic regression analyses, they adjusted for age group and gender among all cohorts, with further adjustments made for smoking and BMI among those enrolled in the SHCS and CoLaus studies.
The researchers found the rates of multimorbidity were 26% in the CoLaus cohort, 13% in the FIRE cohort and 27% in the SHCS cohort. Compared with non-smoking participants in CoLaus study, the incidence of CVD was increased among smokers but was independent of HIV status. Multivariable Poisson regression revealed that compared to non-smoking HIV-negative individuals, HIV infection was associated with higher instances of hypertension, kidney insufficiency and liver disease. Diabetes was not associated with HIV status or smoking status.
“From a clinical perspective, our results suggest that emphasis should be given to smoking cessation and lifestyle interventions,” the researchers wrote. “Further, blood pressure and kidney as well as liver function should be carefully monitored among HIV-patients keeping in mind the increasing risk of drug-drug interactions with increasing polypharmacy.”
Disclosure: The researchers report no relevant disclosures.
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