关注 | 吸烟显著影响艾滋病病毒感染者的健康和寿命
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">本公众号由</span><span style="color: black;">云南省防治艾滋病局</span><span style="color: black;">云南防艾</span><span style="color: black;">”进行关注。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">吸烟有害健康已<span style="color: black;">作为</span>共识，<span style="color: black;">然则</span>吸烟会对艾滋病病毒感染者的健康产生进一步的影响吗?</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">虽然<span style="color: black;">日前</span>尚未见我国关于艾滋病病毒感染者中吸烟比例的调查统计数据，但据美国迈阿密大学的一项调查<span style="color: black;">表示</span>，美国艾滋病病毒感染者吸烟率达到47%，而非艾滋病病毒感染人群的吸烟率仅为25.5%<span style="color: black;"><span style="color: black;">【1】</span></span>，这可能与艾滋病病毒感染人群承受的精神压力大等<span style="color: black;">原因</span><span style="color: black;">相关</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q1.itc.cn/q_70/images03/20240323/2946a6ddef2f4137a7c2fef20538a9db.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">令人担忧的是，许多<span style="color: black;">科研</span><span style="color: black;">发掘</span>，吸烟的艾滋病病毒感染者比不吸烟的艾滋病病毒感染者的预后更差。北加州大学的一项大型<span style="color: black;">科研</span><span style="color: black;">发掘</span>，在20岁的艾滋病病毒感染人群中,吸烟与从不吸烟者的预期寿命差别达到10年<span style="color: black;"><span style="color: black;">【2】</span></span>。另一项针对40岁<span style="color: black;">起始</span>接受抗病毒治疗的艾滋病病毒感染人群的<span style="color: black;">科研</span><span style="color: black;">发掘</span>，吸烟与从不吸烟者，预期寿命差别为6-7年<span style="color: black;"><span style="color: black;">【3】</span></span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">科研</span>还<span style="color: black;">发掘</span>，感染艾滋病病毒的吸烟者患心脏病的<span style="color: black;">危害</span>几乎是未感染艾滋病病毒的吸烟者的三倍，是感染艾滋病病毒戒烟者的两倍<span style="color: black;"><span style="color: black;">【4】</span></span>。<span style="color: black;">一样</span>，感染艾滋病病毒的吸烟者患慢性阻塞性肺病(COPD)和肺癌的<span style="color: black;">危害</span><span style="color: black;">亦</span>比戒烟者或不吸烟者要高<span style="color: black;">非常多</span><span style="color: black;"><span style="color: black;">【5】</span></span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q4.itc.cn/q_70/images03/20240323/4d6171335113459781a474c0be825d37.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">综上，艾滋病病毒感染者戒烟除了能延长预期寿命外，还能降低患癌症、心血管<span style="color: black;">疾患</span>、慢性阻塞性肺病等<span style="color: black;">疾患</span>的<span style="color: black;">危害</span>。<span style="color: black;">因此呢</span>，戒烟是艾滋病病毒感染者延长寿命、<span style="color: black;">加强</span>生活质量的首选。然而，戒烟<span style="color: black;">亦</span>是一个艰难的<span style="color: black;">专题</span>，<span style="color: black;">没</span>论是靠自律和毅力戒烟，还是<span style="color: black;">经过</span><span style="color: black;">药品</span>、电子烟等途径试图达到<span style="color: black;">最后</span>戒烟的目的，艾滋病病毒感染者成功戒烟的比例还不到15%<span style="color: black;"><span style="color: black;">【6】</span></span>。<span style="color: black;">那样</span>，还<span style="color: black;">能够</span>采取<span style="color: black;">那些</span><span style="color: black;">办法</span>来尽可能<span style="color: black;">加强</span>未戒烟艾滋病病毒感染者寿命呢？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q1.itc.cn/q_70/images03/20240323/2bf245aa374b40e2a433c87ebe8ad28a.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">办法</span>当然有。<span style="color: black;">倘若</span><span style="color: black;">不可</span>完全戒烟，<span style="color: black;">能够</span><span style="color: black;">奋斗</span>减少<span style="color: black;">每日</span>的最大吸烟量，并随着时间的推移<span style="color: black;">逐步</span>减少。一项模型<span style="color: black;">科研</span><span style="color: black;">发掘</span>，<span style="color: black;">针对</span>40岁的艾滋病病毒感染者，<span style="color: black;">连续</span>重度吸烟者的肺癌死亡率接近28～29%，而<span style="color: black;">连续</span>轻度吸烟者(<span style="color: black;">每日</span>5支或更少)的肺癌死亡率约为16.5～19%<span style="color: black;"><span style="color: black;">【7】</span></span>。这一结果虽然比戒烟人群（3.7～8%）和从不吸烟人群（1～2%）仍然高不少，但<span style="color: black;">亦</span><span style="color: black;">表示</span>出了<span style="color: black;">极重</span>的改善。<span style="color: black;">倘若</span><span style="color: black;">不可</span>完全戒烟，那就尽可能减少吸烟量吧！</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q0.itc.cn/q_70/images03/20240323/23ec6afe242f44848b1e54ae5149bbf0.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">40岁艾滋病病毒感染者吸烟<span style="color: black;">状况</span>与肺癌死亡率<span style="color: black;">【7】</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q4.itc.cn/q_70/images03/20240323/4417acfaec954bcaa5143bcb51de7d16.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q1.itc.cn/q_70/images03/20240323/b22f1ce3129f4c08acdf3c1f11b7d599.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">最后，不论<span style="color: black;">是不是</span>戒烟或减少吸烟量，都<span style="color: black;">意见</span><span style="color: black;">按照</span>高危程度<span style="color: black;">定时</span>做低剂量CT扫描进行肺癌筛查，<span style="color: black;">初期</span><span style="color: black;">发掘</span>和治疗的肺癌比中晚期或一<span style="color: black;">发掘</span>就<span style="color: black;">已然</span>扩散的<span style="color: black;">病人</span><span style="color: black;">存活</span>率要高得多。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">改变的<span style="color: black;">第1</span>步是<span style="color: black;">加强</span><span style="color: black;">认识</span>。<span style="color: black;">倘若</span>您是一名艾滋病病毒感染者，吸烟者请您<span style="color: black;">尽可能</span>戒烟或减少吸烟量，<span style="color: black;">已然</span>戒烟和从不吸烟者请您继续保持。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q7.itc.cn/q_70/images03/20240323/ffd3db380f5240ecb7407d253b1d44c1.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">参考文献：</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">【1】Asfar T, et al. National Estimates of Prevalence, Time-Trend, and Correlates of Smoking in US People Living with HIV (NHANES 1999-2016). Nicotine Tob Res. 2021;23(8):1308-1317.</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">【2】Marcus JL, et al. Narrowing the Gap in Life Expectancy Between HIV-Infected and HIV-Uninfected Individuals With Access to Care. J Acquir Immune Defic Syndr. 2016;73(1):39-46.</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">【3】Krishna P. et al, Impact of Cigarette Smoking and Smoking Cessation on Life Expectancy Among People With HIV: A US-Based Modeling Study, The Journal of Infectious Diseases, 2016; 214(11):1672–1681,</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">【4】Perkins MV, et al. Cardiovascular Disease and Thrombosis in HIV Infection. Arterioscler Thromb Vasc Biol. 2023;43(2):175-191.</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">【5】Hessol NA, et al. Risk of smoking-related cancers among women and men living with and without HIV. AIDS. 2021;35(1):101-114.</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">【6】Shuter Jonathan, et al. Harm reduction for smokers living with HIV. The Lancet HIV. 2021; 8(10): E652-E658.</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">【7】Reddy KP, et al. Lung Cancer Mortality Associated With Smoking and Smoking Cessation Among People Living With HIV in the United States. JAMA Intern Med. 2017;177(11):1613–1621.</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">源自</span>：中国疾控艾防中心</span></p>
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