Association of cigarette smoking with HIV prognosis among women in the HAART era: a report from the women's interagency HIV study

Am J Public Health. 2006 Jun;96(6):1060-5. doi: 10.2105/AJPH.2005.062745. Epub 2006 May 2.


Objective: We assessed the association of cigarette smoking with the effectiveness of highly active antiretroviral therapy (HAART) among low-income women.

Methods: Data were analyzed from the Women's Interagency HIV Study, a multisite longitudinal study up to 7.9 years for 924 women representing 72% of all women who initiated HAART between July 1, 1995, and September 30, 2003.

Results: When Cox's regression was used after control for age, race, hepatitis C infection, illicit drug use, previous antiretroviral therapy, and previous AIDS, smokers on HAART had poorer viral responses (hazard ratio [HR]=0.79; 95% confidence interval [CI]=0.67, 0.93) and poorer immunologic response (HR=0.85; 95% CI=0.73, 0.99). A greater risk of virologic rebound (HR=1.39; 95% CI=1.06, 1.69) and more frequent immunologic failure (HR=1.52; 95% CI=1.18, 1.96) were also observed among smokers. There was a higher risk of death (HR=1.53; 95% CI=1.08, 2.19) and a higher risk of developing AIDS (HR=1.36; 95% CI=1.07, 1.72) but no significant difference between smokers and nonsmokers in the risk of death due to AIDS.

Conclusions: Some of the benefits provided by HAART are negated in cigarette smokers.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Antiretroviral Therapy, Highly Active / statistics & numerical data*
  • Biomarkers / blood
  • CD4 Lymphocyte Count
  • Disease Progression
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / mortality
  • HIV Infections / pathology
  • HIV-1
  • Humans
  • Kaplan-Meier Estimate
  • Longitudinal Studies
  • Patient Compliance
  • Poverty
  • Prognosis
  • Proportional Hazards Models
  • Smoking / adverse effects*
  • Smoking / epidemiology*
  • Treatment Failure
  • Treatment Outcome*
  • Urban Health
  • Viral Load


  • Biomarkers