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LETTER TO THE EDITOR
Year : 2014  |  Volume : 13  |  Issue : 4  |  Page : 230  

The relationship between smoking, clinical manifestations, and HAART in Nigerian HIV-infected patients


1 Department of Medicine, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Osun, Nigeria
2 Department of Community Medicine, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Osun, Nigeria

Date of Web Publication7-Oct-2014

Correspondence Address:
M O Tanimowo
Department of Medicine, Ladoke Akintola University of Technology Teaching Hospital, P. M. B 5000, Osogbo, Osun
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1596-3519.142298

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How to cite this article:
Tanimowo M O, Akinboro A O, Opadijo O G, Akinleye C A. The relationship between smoking, clinical manifestations, and HAART in Nigerian HIV-infected patients. Ann Afr Med 2014;13:230

How to cite this URL:
Tanimowo M O, Akinboro A O, Opadijo O G, Akinleye C A. The relationship between smoking, clinical manifestations, and HAART in Nigerian HIV-infected patients. Ann Afr Med [serial online] 2014 [cited 2019 Nov 14];13:230. Available from: http://www.annalsafrmed.org/text.asp?2014/13/4/230/142298

Sir,

Since the introduction of the highly-active antiretroviral therapy HAART, there has been significant improvement in the overall clinical conditions and survival of patients with the human immunodeficiency virus HIV and the acquired immune deficiency syndrome AIDS. [1] But HAART is not without its own consequences on the health of HIV/AIDS patients. [2]

It has also been observed that because of the increased survival of HIV/AIDS patients, cigarette smoking is taking its toll on this group of people, further exposing them to all its attendant health risks some of which are similar to the side effects of HAART such as hypercoagulation and atherosclerosis, [2] thereby making HIV/AIDS patients susceptible to increased risk of cardiovascular disease. [3]

We studied the relationship between smoking status, clinical manifestations, and HAART in 194 Nigerian HIV-infected patients using a questionnaire to obtain information on HAART use and duration, clinical manifestations at diagnosis, and smoking status.

No statistical significance was found between the smoking status of the patients and either the use of HAART or duration of use. Compared to the never-smoked group, ex-smokers were significantly more likely to have weight loss (odd's ratio (OR) 21.40, 95% confidence interval (CI) 5.55-96.5); anemia (OR 5.23, 95% CI 11.89-14.72); lymphadenopathy 3.98, 95% CI 1.20-12.38); and comorbidities OR 2.59, 95% CI 0.84-8.46. Compared to the never smoked group, the current smokers had statistical similarity with the ex-smokers.

Our finding implies that smoking is probably not a determinant of HAART use in Nigerian HIV/AIDS patients despite the fact that smoking HIV/AIDS patients generally have worse symptoms at diagnosis. [4] It also suggests that stopping smoking may hinder the development of weight loss, anemia, lymphadenopathy, and co-morbidities in people living with HIV and AIDS PLWHIVs. There is evidence that smoking induces weight loss while quitting smoking induces weight gain in the general population. The nicotine in tobacco speeds body metabolism and also causes a decrease in appetite. [5] Anemia and lymphadenopathy are known to occur very commonly among HIV/AIDS patients and the study suggests that they occur more frequently among the smokers.

The possible protective effect of quitting smoking among HIV/AIDS patients concerning weight loss, anemia, and lymphadenopathy deserves further study to elucidate the pathophysiological mechanism(s). Antismoking programs need to be commenced among Nigerian PLWHIVs.

 
   References Top

1.Pallela FJ Jr, Delaney KM, Moorman AC, Loveless MO, Fuhrer J, Satten GA, et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV out patient investigators. N Eng J Med 1998;388:853-60.  Back to cited text no. 1
    
2.Carr A, Cooper DA. Adverse effects of antiretroviral therapy. Lancet 2000;356:1423-30.  Back to cited text no. 2
    
3.Lifson AR, Neuhaus J, Arribas JR, van den Berg-Wolf M, Labriola AM, Read TR. INSIGHT SMART Study Group. Smoking-related health risks among persons with HIV in the Strategies for Management of Antiretroviral Therapy clinical trial. Am J Public Health 2010;100:1896-903.  Back to cited text no. 3
    
4.Neiman RB, Fleming J, Coker RJ, Harris JR, Mitchell DM. The effect of cigarette smoking on the development of AIDS in HIV-1 positive individuals. AIDS 1993;7:705-10.  Back to cited text no. 4
    
5.Brennan C. Smoking can have negative impact on simmune response to HAART. HIV Clin 2013;25:6-9.  Back to cited text no. 5
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