The interrelationship of smoking, CD4(+) cell count, viral load and cancer in persons living with HIV
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The interrelationship of smoking, CD4(+) cell count, viral load and cancer in persons living with HIV. / Mocroft, A.; Petoumenos, Kathy; Wit, F.; Vehreschild, J. J.; Guaraldi, G.; Miro, J. M.; Greenberg, L.; Oellinger, A.; Egle, A.; Guenthard, H. F.; Bucher, H. C.; De Wit, S.; Necsoi, C.; Castagna, A.; Spagnuolo, Vincenzo; Monforte, A. D'Arminio; Reiss, P.; Chkhartishvili, N.; Bolokadze, N.; Hoy, J.; Sonnenborg, A.; Svedhem, Veronica; Bower, M.; Volny-Anne, A.; Garges, H.; Rogatto, F.; Neesgaard, B.; Peters, L.; Lundgren, J. D.; Ryom, L.; RESPOND Study Grp.
In: AIDS, Vol. 35, No. 5, 2021, p. 747-757.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - The interrelationship of smoking, CD4(+) cell count, viral load and cancer in persons living with HIV
AU - Mocroft, A.
AU - Petoumenos, Kathy
AU - Wit, F.
AU - Vehreschild, J. J.
AU - Guaraldi, G.
AU - Miro, J. M.
AU - Greenberg, L.
AU - Oellinger, A.
AU - Egle, A.
AU - Guenthard, H. F.
AU - Bucher, H. C.
AU - De Wit, S.
AU - Necsoi, C.
AU - Castagna, A.
AU - Spagnuolo, Vincenzo
AU - Monforte, A. D'Arminio
AU - Reiss, P.
AU - Chkhartishvili, N.
AU - Bolokadze, N.
AU - Hoy, J.
AU - Sonnenborg, A.
AU - Svedhem, Veronica
AU - Bower, M.
AU - Volny-Anne, A.
AU - Garges, H.
AU - Rogatto, F.
AU - Neesgaard, B.
AU - Peters, L.
AU - Lundgren, J. D.
AU - Ryom, L.
AU - RESPOND Study Grp
PY - 2021
Y1 - 2021
N2 - Background: It is unknown if the carcinogenic effect of smoking is influenced by CD4(+) cell count and viral load in persons living with HIV. Material and methods: RESPOND participants with known smoking status were included. Poisson regression adjusting for baseline confounders investigated the interaction between current CD4(+)/viral load strata [good (CD4(+) cell count >= 500 cells/mu l and viral load 200 copies/ml] and intermediate [all other combinations]), smoking status and all cancers, non-AIDS defining cancers (NADCs), smoking-related cancers (SRCs) and infection-related cancers (IRCs). Results: Out of 19 602 persons, 41.3% were never smokers, 44.4% current and 14.4% previous smokers at baseline. CD4(+)/viral load strata were poor in 3.4%, intermediate in 44.8% and good in 51.8%. There were 513 incident cancers; incidence rate 6.9/1000 person-years of follow-up (PYFU) [95% confidence interval (95% CI) 6.3-7.5]. Current smokers had higher incidence of all cancer (adjusted incidence rate ratio 1.45; 1.17-1.79), NADC (1.65; 1.31-2.09), SRC (2.21; 1.53-3.20) and IRC (1.38; 0.97-1.96) vs. never smokers. Those with poor CD4(+)/viral load had increased incidence of all cancer (5.36; 95% CI 3.71-7.75), NADC (3.14; 1.92-5.14), SRC (1.82; 0.76-4.41) and IRC (10.21; 6.06-17.20) vs. those with good CD4(+)/viral load. There was no evidence that the association between smoking and cancer subtypes differed depending on the CD4(+)/viral load strata (P > 0.1, test for interaction). Conclusion: In the large RESPOND consortium, the impact of smoking on cancer was clear and reducing smoking rates should remain a priority. The association between current immune deficiency, virological control and cancer was similar for never smokers, current smokers and previous smokers suggesting similar carcinogenic effects of smoking regardless of CD4(+) cell count and viral load.
AB - Background: It is unknown if the carcinogenic effect of smoking is influenced by CD4(+) cell count and viral load in persons living with HIV. Material and methods: RESPOND participants with known smoking status were included. Poisson regression adjusting for baseline confounders investigated the interaction between current CD4(+)/viral load strata [good (CD4(+) cell count >= 500 cells/mu l and viral load 200 copies/ml] and intermediate [all other combinations]), smoking status and all cancers, non-AIDS defining cancers (NADCs), smoking-related cancers (SRCs) and infection-related cancers (IRCs). Results: Out of 19 602 persons, 41.3% were never smokers, 44.4% current and 14.4% previous smokers at baseline. CD4(+)/viral load strata were poor in 3.4%, intermediate in 44.8% and good in 51.8%. There were 513 incident cancers; incidence rate 6.9/1000 person-years of follow-up (PYFU) [95% confidence interval (95% CI) 6.3-7.5]. Current smokers had higher incidence of all cancer (adjusted incidence rate ratio 1.45; 1.17-1.79), NADC (1.65; 1.31-2.09), SRC (2.21; 1.53-3.20) and IRC (1.38; 0.97-1.96) vs. never smokers. Those with poor CD4(+)/viral load had increased incidence of all cancer (5.36; 95% CI 3.71-7.75), NADC (3.14; 1.92-5.14), SRC (1.82; 0.76-4.41) and IRC (10.21; 6.06-17.20) vs. those with good CD4(+)/viral load. There was no evidence that the association between smoking and cancer subtypes differed depending on the CD4(+)/viral load strata (P > 0.1, test for interaction). Conclusion: In the large RESPOND consortium, the impact of smoking on cancer was clear and reducing smoking rates should remain a priority. The association between current immune deficiency, virological control and cancer was similar for never smokers, current smokers and previous smokers suggesting similar carcinogenic effects of smoking regardless of CD4(+) cell count and viral load.
KW - cancer
KW - immune suppression
KW - smoking
KW - viral replication
KW - AIDS-DEFINING MALIGNANCIES
KW - ANTIRETROVIRAL THERAPY
KW - CIGARETTE-SMOKING
KW - LUNG-CANCER
KW - INFECTED INDIVIDUALS
KW - TOBACCO SMOKING
KW - HARM REDUCTION
KW - RISK-FACTORS
KW - NICOTINE
KW - POPULATION
U2 - 10.1097/QAD.0000000000002791
DO - 10.1097/QAD.0000000000002791
M3 - Journal article
C2 - 33306554
VL - 35
SP - 747
EP - 757
JO - AIDS
JF - AIDS
SN - 1350-2840
IS - 5
ER -
ID: 302096415