Résumé :
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[BDSP. Notice produite par INIST-CNRS 6OvQR0xD. Diffusion soumise à autorisation]. 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 [Cl]=0.67,0.93) and poorer immunologic response (HR=0.85 ; 95% Cl=0.73,0.99). A greater risk of virologic rebound (HR=1.39 ; 95% Cl=1.06,1.69) and more frequent immunologic failure (HR=1.52 ; 95% Cl=1.18,1.96) were also observed among smokers. There was a higher risk of death (HR=1.53 ; 95% Cl=1.08,2.19) and a higher risk of developing AIDS (HR=1.36 ; 95% Cl=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.
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