Lung and Heart Diseases Are Better Predicted by Pack-Years than by Smoking Status or Duration of Smoking Cessation in HIV Patients |
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Authors: | Giovanni Guaraldi Paolo Raggi André Gomes Stefano Zona Enrico Marchi Antonella Santoro Giulia Besutti Riccardo Scaglioni Guido Ligabue Jonathon Leipsic Paul Man Don Sin |
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Institution: | 1. Modena HIV Metabolic Clinic, UNIMORE, Modena, Italy.; 2. Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada.; 3. Infectious Diseases Department, Hospital Garcia de Orta, Almada, Portugal.; 4. Radiology Unit, UNIMORE, Modena, Italy.; 5. Department of Radiology, University of British Columbia, Vancouver, Canada.; 6. Department of Medicine (Respiratory Division), University of British Columbia, Vancouver, Canada.; University of Missouri-Kansas City, UNITED STATES, |
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Abstract: | BackgroundThe objective of this study was to assess the relationship of pack-years smoking and time since smoking cessation with risk of lung and heart disease.MethodsWe investigated the history of lung and heart disease in 903 HIV-infected patients who had undergone thoracic computed tomography (CT) imaging stratified by smoking history. Multimorbidity lung and heart disease (MLHD) was defined as the presence of ≥ 2 clinical or subclinical lung abnormalities and at least one heart abnormality.ResultsAmong 903 patients, 23.7% had never smoked, 28.7% were former smokers and 47.6% were current smokers. Spirometry indicated chronic obstructive pulmonary disease in 11.4% of patients and MLHD was present in 53.6%. Age, male sex, greater pack-years smoking history and smoking cessation less than 5 years earlier vs. more than 10 years earlier (OR 2.59, 95% CI 1.27–5.29, p = 0.009) were independently associated with CT detected subclinical lung and heart disease. Pack-years smoking history was more strongly associated with MLHD than smoking status (p<0.001).ConclusionsMLHD is common even among HIV-infected patients who never smoked and pack- years smoking history is a stronger predictor than current smoking status of MLHD. A detailed pack-years smoking history should be routinely obtained and smoking cessation strategies implemented. |
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