Smoking Multiplies Cancer Risk in Patients with HIV

Patients with HIV who smoke may be at even greater risk of developing smoking-related cancers.

In a recent issue of the journal AIDS, researchers at the University of Copenhagen in Denmark used data from a Denmark-wide cohort study to assess the risk of smoking-related cancers in patients with HIV.

Using registry data collected between 1995 and 2011, researchers compared the risk of smoking-related in cancers in smokers, never smokers, and former smokers with, and without HIV.

Investigators defined smoking-related cancers as lung cancer, head and neck cancer, esophageal cancer, and bladder cancer. More than three-fourths (77%) of patients involved the study were using antiretroviral therapy and patients’ baseline CD4+ T cell count averaged 450 cells/mL.

Of 2302 patients with HIV, the risk of developing a new smoking-related cancer was 2.8 times (95% CI 1.6 to 4.9) as likely as in 12,979 HIV-free patients from the general population.

Patients with HIV who choose to smoke increase their risk of smoking-related cancers by a factor of 21—a significantly larger increase than the 4-fold increase in risk than would be expected in HIV-free individuals who started the habit (see Figure 1).

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The same group of researchers previously reported a loss of 12.3 expected years of life through the combination of HIV and smoking (95% CI, 8.1 to 16.4).

These findings underscore the importance of tobacco cessation programs in patients with HIV infection.

References:

• Helleberg M, Gerstoft J, Afzal S, et al. Risk of cancer among HIV-infected individuals compared to the background population: impact of smoking and HIV. AIDS. 2014.
• Helleberg M, Afzal S, Kronborg G, et al. Mortality attributable to smoking among HIV-1-infected individuals: a nationwide, population-based cohort study. Clin Infect Dis. 2013;56(5):727-734.