Is smoking tobacco an independent risk factor for HIV infection and progression to AIDS? A systemic review
- 1South East Sheffield Primary Care Trust, 9 Orgreave Road, Sheffield S13 9LQ, UK
- 2Public Health GIS Unit, School of Health and Related Research, University of Sheffield, Regents Court, 30 Regent Street, Sheffield S1 4DA, UK
- 3Institute of Health Sciences and Public Health Research, 71-75 Clarendon Road, University of Leeds, Leeds LS2 9PL, UK
- 4School of Health and Related Research, University of Sheffield, Regents Court, 30 Regent Street, Sheffield S1 4DA, UK
- Correspondence to: Dr Andrew Furber South East Sheffield Primary Care Trust, 9 Orgreave Road, Sheffield S13 9LQ, UK;
- Accepted 29 July 2006
- Published Online First 21 August 2006
Objectives: To systematically review the evidence of the relation between smoking tobacco and HIV seroconversion and progression to AIDS.
Methods: A systematic review was undertaken of studies to look at tobacco smoking as a risk factor for either HIV seroconversion or progression to AIDS.
Results: Six studies were identified with HIV seroconversion as an outcome measure. Five of these indicated that smoking tobacco was an independent risk factor after adjusting for important confounders with adjusted odds ratios ranging from 1.6 to 3.5. 10 studies were identified using progression to AIDS as an end point of which nine found no relation with tobacco smoking.
Conclusions: Tobacco smoking may be an independent risk factor for HIV infection although residual confounding is another possible explanation. Smoking did not appear to be related to progression to AIDS although this finding may not be true in developing countries or with the longer life expectancies seen with highly active antiretroviral therapy.
- CI, confidence interval
- DALYs, disability adjusted life years
- HAART, highly active antiretroviral therapy
- OR, odds ratio
- PCP, Pneumocystis carinii pneumonia
- RH, relative hazard
- RR, relative risk
Published Online First 21 August 2006
Funded by the University of Sheffield Academic Development Committee funds. The views expressed are those of the authors and not necessarily their employing or funding organisations.
Competing interests: none