H.I.V. patients who obtain good treatment but who smoke lose more years of life to tobacco than to the virus, a new Danish study has found.
The study, which looked at nearly 3,000 Danish H.I.V. patients from 1995 - the year antiretroviral triple therapy became standard - to 2010, was published online last month by the journal Clinical Infectious Diseases.
A 35-year-old H.I.V. patient who did not smoke was likely to live to age 78, while one who smoked was likely to die before age 63, the report found.
(The study’s authors said they excluded people who inject drugs, even though most addicts smoke, because their “risk-taking behavior” and causes of death “differ significantly from the rest of the H.I.V.-infected population.”)
The study also compared Danish H.I.V. patients with a pool of 10,642 average Danes of the same age and sex. H.I.V. appeared to make smoking much more lethal. The risk of early death from cancer or heart disease was much higher among infected smokers than among noninfected ones, and smoking was more closely linked to early death than was obesity, excess drinking or baseline viral load (a measure of how sick a patient was at diagnosis).
Denmark has universal health care. H.I.V. drugs are free and care is coordinated by AIDS centers around the country. “Treatment failures and loss to follow-up are rare,” the study said. It urged doctors to strongly advise their H.I.V. patients to quit smoking.