The research team found that nearly 25 percent of HIV patients who take their medication but continue to smoke will die from lung cancer. Heavy smokers are at even greater risk, with about 30 percent dying from lung cancer.
Overall, people with HIV who smoke and adhere to their drug regimen are 6 to 13 times more likely to die from lung cancer than HIV/AIDS, depending on how intensely they smoke and whether they are male or female, the researchers reported.
“It turns out that lung cancer is now one of the leading causes of death for people with HIV, particularly among those who are on treatment,” Reddy said.
Quitting can drastically alter those odds, researchers found. Only about 8 percent of heavy smokers who quit by age 40 are expected to die from lung cancer, and the odds are even better for moderate and light smokers, the researchers said.
The computer model “makes a very strong case for increased smoking cessation efforts in centers that treat people infected with HIV,” said Dr. Norman Edelman, senior scientific advisor for the American Lung Association.
“I think that clinics and centers that take care of patients with HIV should add smoking cessation to their toolbox,” Edelman said. “It’s just as important as making sure they eat right and are protected from infections by other agents.”
Patients and doctors need to adopt a new view of HIV’s relative risks in the face of medical breakthroughs, Reddy said.
“Smoking isn’t very high on the radar when it comes to people with HIV,” Reddy said. “It’s often lower down on the priority list, when, in fact, today for a person with HIV who’s on treatment the No. 1 cause of death isn’t the virus. It’s smoking.”
The new study was published Sept. 18 in JAMA Internal Medicine.
SOURCES: Krishna Reddy, M.D., pulmonologist and critical care doctor, Massachusetts General Hospital, Boston; Norman Edelman, M.D., senior scientific advisor, American Lung Association; JAMA Internal Medicine, Sept. 18, 2017