MEDICAL UPDATE: Effect of Smoking on Disease Progression

MEDICAL UPDATE: Effect of Smoking on Disease Progression

Being Alive Newsletter; Beling Alive/Los Angeles - September 93
Mark Katz MD and reported by Jim Stoecker

There has been a great deal of controversy on the role of cigarette smoking in the progression of HIV disease. Of course, we know that smoking is, in general, detrimental to one's health. Up to now, we did not have evidence of smoking as a cofactor in AIDS progression.

Now we have a study conducted in London on the effect of cigarette smoking on the development of AIDS in HIV+ individuals. The study compared 41 non-smokers to 43 smokers (half a pack or more per day). The median time for progression to AIDS in non-smokers was 14.5 months vs. 8.17 months in smokers. Smokers averaged one case of PCP per 9-month period; non-smokers averaged one case per 16-month period.

The question remains whether there is cause and effect at work here. Past studies have noted that smokers generally seem to have higher CD4 counts than non-smokers. The London researchers, however, found that CD4 function among smokers was not as strong as among non-smokers, even though counts were found to be higher. They postulate that smoking may activate T-lymphocytes and that this process may in turn activate HIV in cells already infected.
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