AEGiS-08IAC: Heavy smoking increases the risk of Pneumocystis carinii pneumonia (PCP).

8th International AIDS Conference


Amsterdam, Netherlands — July 19-24, 1992

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Heavy smoking increases the risk of Pneumocystis carinii pneumonia (PCP).

Int Conf AIDS 1992 Jul 19-24; 8:We50 (abstract no. WeC 1030)
Buskin SE, Hopkins SG, Farizo KM; Seattle-King County Department of Public Health, WA.

INTRODUCTION: PCP is the most frequent AIDS-defining illness. Although previous studies have found no association between PCP and cigarette smoking, no reports have examined the association using various levels of smoking, as measured by pack-years.

METHODS: As part of a CDC-funded surveillance project, medical records of 1204 HIV seropositive persons were examined at seven outpatient sites in Seattle during 1990-1991.

RESULTS: To exclude persons at minimal risk of PCP, the analysis was limited to persons with CD4 counts less than 500 with known smoking status (n = 598). There were 325 current smokers and 273 nonsmokers. Of the nonsmokers, 54 were known to be ex-smokers, 29 were never smokers, and the remaining 190 (70%) could not be further classified. Because the number of never smokers was small and because many current nonsmokers were likely to be ex-smokers with a high risk of PCP (odds ratio = 5.2 for ex-smokers relative to light smokers), light smokers (lowest pack-year tercile, less than 12 pack-years) were used as a reference group. One hundred and twenty-six persons (21%) had one or more episode(s) of PCP. There was a strong dose-response effect for intermediate smokers (12 to 19 pack-years) and heavy smokers (20+ pack-years) when looking at the outcome of ever having had PCP (Chi square for trend = 9.4, p = .002). The crude relative odds of PCP for the intermediate and heavy smokers were 3.1 (95% CI = 0.8-13.0) and 5.6 (95% CI = 1.6-21.7), respectively. After adjustment for CD4 count, gender, ethnicity, and use of PCP prophylaxis by logistic regression, the odds of PCP were 2.9 (95% CI = 0.9-10.2) for intermediate and 3.5 (95% CI = 1.1-11.2) for heavy smokers.

CONCLUSION: Heavy smokers were over 3 times more likely to have had PCP than were light smokers. These results may have clinical implications in the future, and provide HIV positive smokers with another reason to quit smoking.

Keywords: AEGIS, Pneumonia, Pneumocystis carinii, Smoking, Risk, Odds Ratio, Smoking Cessation, CD4 Lymphocyte Count, HIV Seropositivity, Risk Factors, HIV Infections, Substance-Related Disorders, Multivariate Analysis, ICA8KWDaegis,pneumonia,pneumocystiscarinii,smoking,risk,oddsratio,smokingcessation,cd4lymphocytecount,hivseropositivity,riskfactors,hivinfections,substance-relateddisorders,multivariateanalysis,ica8
920719
WeC1030

Copyright © 1992 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.