Inflammation associated with severe tobacco smoking among people with HIV

Inflammation in the body has been linked to the severity of tobacco smoking among people with HIV, according to a team of University of Massachusetts Amherst researchers.

Krishna Poudel, associate professor of community health education in the School of Public Health and Health Sciences, and colleagues described positive serial relationships between the intensity, duration and packaged years of smoking and inflammation in people with HIV . They believe this is the first more detailed study of specific variables associated with smoking with the inflammation levels in this group, while also focusing on antiretroviral therapy (HAART). is highly functional and other important factors.

The findings of the study suggest that people living with HIV would benefit not only from quitting smoking but from smoking less, says Poudel, co-director of the Institute UMass Amherst for Global Health. Poudel is the lead author of the paper which was published in a March issue of the journal AIDS and Behavior.

“While it is important to support and encourage people living with HIV to eventually stop smoking, it is also important to recommend that they reduce the frequency of smoking so that they can quit altogether. . That would help their health status by reducing inflammation, “says Poudel, noting that a high rate of slam is associated with an increased risk of disease and death in people living with HIV.

Importantly, people with HIV who receive HAART are at greater risk of dying from tobacco than from HIV-related factors.

In 2010, Poudel and co-author Kalpana Poudel-Tandukar, a UMass Amherst associate professor of nursing, founded the research group called Positive Living with HIV (POLH). The public health researchers collaborated with five non-governmental organizations (NGOs) to recruit 322 HIV-positive people living in Nepal’s Kathmandu Valley. Their aim was to gather behavioral, health and biological information from participants to learn ways to improve the health and well-being of people with HIV, especially those in low- and middle-income countries. .

The paper Smoking and Inflammation, owned by UMass Amherst co-authors also includes epidemiologist Elizabeth Bertone-Johnson and biostatistician Penelope Pekow, is the 18th publication in a peer-reviewed journal related to POLH cohort study.

For the most recent study, the researchers interviewed 284 study participants, gathering details about their smoking and medical history and other relevant information, such as whether they were receiving HAART. They asked how many cigarettes were smoked per day (intensity) and how many years (duration). Lifetime smoking measurements were measured in package years, which is determined by multiplying the number of packs smoked per day by the number of years the person has smoked.

The team then measured C-reactive serum protein (CRP), a pro-inflammatory biomarker, and several strong predictors of inflammation in the participants. They adjusted for these variables while examining the relationships between smoking and inflammation, using both serial and logistic withdrawal statistical analyzes.

We adjusted for zinc levels and hepatitis C. We adjusted for HAART status and CD4 cell counts. We adjusted for depression and history of injecting drug use. We modified 16 HIV-related symptoms, too. “

Krishna Poudel, Associate Professor, Community Health Education, School of Public Health and Health Sciences

In each of the dose-response categories, researchers found a positive relationship between smoking and inflammation, although Poudel says the cross-sectional design of the study cannot determine a cause.

“A significantly higher proportion of participants with high-intensity smoking (number of cigarettes smoked per day) had higher levels of CRP concentrations compared to those with low-smoking status,” the paper notes. say.

The researchers found similar results in terms of smoking length and packaging years of smoking; that is, participants who smoked for longer periods and those with packing years were more likely to have high levels of CRP than those who smoked for shorter periods and had fewer of package years.

The next step is to develop effective smoking reduction and cessation programs for people with HIV, whose tobacco use rate is two to three times higher than that of the general population. This is especially important in low- and middle-income countries, where such education and support are rarely available, Poudel says.

“Many people with HIV in low- and middle-income countries are willing to stop smoking and need support,” Poudel says. “Our findings reflect an urgent need for cessation support. giving people smoking with HIV. While support for people with HIV to stop smoking is a public health priority, HIV care providers should at least encourage their patients to reduce the incidence of smoking, as this would be a positive step to stopping smoking. put on smoking. “