Got HIV? Higher Pneumonia Risk With Smoking

HIV positive people may have high risk for bacterial pneumonia if they smoke

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Smoking is unhealthy for the healthiest of people. But for people with human immunodeficiency virus (HIV), smoking is even worse. Want to stay healthy with HIV? Quit smoking now.

A recent review looked at past studies that included people with HIV, their smoking habits and risk of bacterial pneumonia and fungal pneumonia.

Results showed a significant increase in the risk for bacterial pneumonia for HIV patients who currently smoke. Analysis showed that quitting smoking lowered this risk.

"Call 1-800-QUIT-NOW."

Paul Aveyard, PhD, MPH, Professor of Behavioral Medicine at the University of Oxford and NIHR Career Scientist at the University of Birmingham in the UK, led a team of colleagues to investigate the role of smoking with regard to the risk of developing pneumonia in people with HIV.

Researchers looked through medical databases for studies involving patients with HIV, information on their smoking habits and the incidence of both bacterial pneumonia and pneumonia caused by Pneumocystis jiroveci (PCP).

PCP is a fungal infection of the lungs and does not typically occur in healthy people. PCP occurs as a complication in people with compromised immune systems from cancer, HIV/AIDS, organ transplant or long-term use of medications that weaken the immune system. Bacterial pneumonia is relatively common across all groups.

For the research, 14 studies were selected from databases spanning between 1947 to 2010. The studies included 1,409 participants from the US, Europe and South Africa.

Researchers found that current smokers had a 37 percent increased risk of catching bacterial pneumonia compared to former smokers. Former smokers did not appear to have a greater risk of developing bacterial pneumonia compared to those who never smoked.

No significant increase was found in the incidence of PCP in relation to smoking habits.

“We found strong statistical evidence that, in patients with HIV, current smoking was associated with an approximate 70 percent to 100 percent increased risk of bacterial pneumonia compared with non-smokers, and moderate evidence that stopping smoking decreased this by about 27 percent,” the authors said.

“This means that 25 percent of smokers would develop pneumonia over 10 years due to their smoking that would have been prevented by smoking cessation. Of cases of pneumonia in people with HIV, 22 percent are due to current smoking [based on the averages found in this review],” they said.

The authors reasoned that “brief advice” from a doctor to quit smoking has not been sufficient in the past and will not be so in the future. They called for greater smoking cessation efforts by healthcare professionals for people with HIV.

The authors noted that smoking cessation efforts would be far more cost effective than treating smoking-related complications in patients with HIV.

This study was published in January in BMC Medicine.

No special funding was used for this study. However, various UK and US public health research organizations supported authors individually. No conflicts of interest were found.

Reviewed by: 
Review Date: 
January 21, 2013
Last Updated:
August 19, 2013