Strong Impact of Smoking on Multimorbidity and Cardiovascular Risk Among Human Immunodeficiency Virus-Infected Individuals in Comparison With the General Population

Article Article scientifique Article Strong Impact of Smoking on Multimorbidity and Cardiovascular Risk Among Human Immunodeficiency Virus-Infected Individuals in Comparison With the General Population eng 2015 author Hasse Barbara author Tarr Philip E author Marques-Vidal Pedro author Waeber Gerard author Preisig Martin author Mooser Vincent author Valeri Fabio author Djalali Sima author Andri Rauch author Bernasconi Enos 663410 author Calmy Alexandra 0000-0002-1137-6826 41032 author Cavassini Matthias author Vernazza Pietro author Battegay Manuel author Weber Rainer author Senn Oliver author Vollenweider Peter 724488 author Ledergerber Bruno collaborator Burton-Jeangros Claudine 0000-0003-2258-9728 29914 collaborator Kaiser Laurent 28229 author Martinetti Gregory 97156 collaborator Aubry Jean-Michel 32998 collaborator Bochud Murielle 41043 collaborator Gaspoz Jean-Michel 126367 collaborator Frei Markus 50911 Cohorte Lausannoise FIRE Swiss HIV Cohort Study ofv108 10.1093/ofid/ofv108 26284258 2328-8957 Background. Although acquired immune deficiency syndrome-associated morbidity has diminished due to excellent viral control, multimorbidity may be increasing among human immunodeficiency virus (HIV)-infected persons compared with the general population. Methods. We assessed the prevalence of comorbidities and multimorbidity in participants of the Swiss HIV Cohort Study (SHCS) compared with the population-based CoLaus study and the primary care-based FIRE (Family Medicine ICPC-Research using Electronic Medical Records) records. The incidence of the respective endpoints were assessed among SHCS and CoLaus participants. Poisson regression models were adjusted for age, sex, body mass index, and smoking. Results. Overall, 74 291 participants contributed data to prevalence analyses (3230 HIV-infected; 71 061 controls). In CoLaus, FIRE, and SHCS, multimorbidity was present among 26%, 13%, and 27% of participants. Compared with nonsmoking individuals from CoLaus, the incidence of cardiovascular disease was elevated among smoking individuals but independent of HIV status (HIV-negative smoking: incidence rate ratio [IRR] = 1.7, 95% confidence interval [CI] = 1.2-2.5; HIV-positive smoking: IRR = 1.7, 95% CI = 1.1-2.6; HIV-positive nonsmoking: IRR = 0.79, 95% CI = 0.44-1.4). Compared with nonsmoking HIV-negative persons, multivariable Poisson regression identified associations of HIV infection with hypertension (nonsmoking: IRR = 1.9, 95% CI = 1.5-2.4; smoking: IRR = 2.0, 95% CI = 1.6-2.4), kidney (nonsmoking: IRR = 2.7, 95% CI = 1.9-3.8; smoking: IRR = 2.6, 95% CI = 1.9-3.6), and liver disease (nonsmoking: IRR = 1.8, 95% CI = 1.4-2.4; smoking: IRR = 1.7, 95% CI = 1.4-2.2). No evidence was found for an association of HIV-infection or smoking with diabetes mellitus. Conclusions. Multimorbidity is more prevalent and incident in HIV-positive compared with HIV-negative individuals. Smoking, but not HIV status, has a strong impact on cardiovascular risk and multimorbidity. Dewey 613 Dewey 616 Dewey 616.89 56 Département de médecine 221 60 Département de psychiatrie 225 201 Institut de médecine de premier recours 22A9 false 16 Groupe Jean-Michel Gaspoz 23 400 Groupe Laurent Kaiser (virologie clinique) 668 Open forum infectious diseases 2 3 618c2d1b-8d65-4e46-982f-d6b5cb4c5e9e Article (Published version) Public Strong.pdf 235175 application/pdf openAccess Faculté de médecine / Section de médecine clinique / Département de médecine Faculté de médecine / Section de médecine clinique / Département de psychiatrie Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires / Institut de médecine de premier recours

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Strong Impact of Smoking on Multimorbidity and Cardiovascular Risk Among Human Immunodeficiency Virus-Infected Individuals in Comparison With the General Population	Open forum infectious diseases			2015	601	247

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