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Observational Study
. 2025 Feb 1;39(2):143-152.
doi: 10.1097/QAD.0000000000004042. Epub 2024 Oct 21.

Impact of smoking habits on cardiovascular and neoplastic events and all-cause death in people with HIV from the STOPSHIV cohort

Giuseppe Vittorio De Socio  1 , Elena Ricci  2 , Stefania Piconi  3 , Nicola Squillace  4 , Paolo Maggi  5 , Giancarlo Orofino  6 , Debora Altobelli  1 , Carmen Santoro  7 , Marta Guastavigna  6 , Barbara Menzaghi  8 , Elena Salomoni  9 , Antonio Di Biagio  10 , Marco dell'Omo  11 , Daniela Francisci  1 , Paolo Bonfanti  4 ; for CISAI study group (Italian coordination group for the study of allergies, HIV infection)
Affiliations
Observational Study

Impact of smoking habits on cardiovascular and neoplastic events and all-cause death in people with HIV from the STOPSHIV cohort

Giuseppe Vittorio De Socio et al. AIDS. .

Abstract

Objective: The study aimed to assess the impact of smoking exposure on major clinical events (MCEs) in a real-life setting of people with HIV (PWH).

Design: An observational, longitudinal, multicenter cohort study from Italy.

Methods: Consecutive 983 PWH were enrolled in "STOP Smoking in HIV people" (STOPSHIV) projects and followed from July 2014 until September 2023. The observed MCE defined as cardiovascular events, neoplastic diseases, or death for any reason was assessed according to smoking status and related variables (number of cigarettes smoked daily, pack-years, Fagerström test) in participants. The association between exposure variables and the event was evaluated using the Cox proportional hazard model [hazard ratios, and 95% confidence interval (95% CI)].

Results: Over 6997.6 person-years of follow-up (PYFU), we found a total of 49 cardiovascular events, 61 neoplastic events, and 47 deaths. The overall incidence rate of MCE was 17.6 /1000 PYFU (95% CI 14.7-21.0). All-cause death rate was 6.7 (95% CI 5.0-8.9)/1000 PYFU. In a multivariate analysis, older age (hazard ratio 1.07, CI 1.05-1.09), high Fagerström Test for Nicotine Dependence (hazard ratio 1.09, CI 1.03-1.15), a low nadir CD4 + cell count less than 200 cells/μl (hazard ratio 1.63, CI 1.10-1.41), history of previous neoplasm (hazard ratio 2.41; CI 1.34-4.43), and IDU as a risk factor for HIV infection (hazard ratio 2.36; CI 1.52-3.68) were independent predictors of any MCE.

Conclusion: Non-AIDS clinical conditions are the most observed clinical events in PWH from Italy. Smoking exposure significantly increases the risk of MCE in PWH, and a high Fagerström Test for Nicotine Dependence is a predictor of MCE.

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