HIV Clinical Trial
Official title:
A Smoking Cessation Trial in HIV-infected Patients in South Africa
The purpose of this study is to conduct a randomized controlled trial (RCT) of intensive anti-smoking counseling plus nicotine replacement therapy versus intensive anti-smoking counseling alone among HIV-infected patients in South Africa, and to concurrently measure the prevalence of smoking among HIV-infected patients in South Africa.
Tobacco use is estimated to be responsible for over 5 million deaths globally every year and
HIV/AIDS kills 2 million worldwide, with persons living in the developing world especially at
risk. However, the association between tobacco use and HIV is not clearly understood. The
introduction of highly active antiretroviral therapy (HAART) has led to longer duration of
survival following HIV-infection in the developed world, and now that HAART is being rolled
out in the developing world, survival will increase in these highly endemic regions as well.
Given this increase in survival, more people will die of non-HIV related illnesses for which
smoking plays an important causal role. Smoking cessation for HIV-infected persons has been
studied in the US though these studies have had small numbers and limited follow-up. US based
studies suggest that approaches that combine nicotine replacement therapy (NRT) and
counseling interventions are most successful. Optimal approaches in resource-limited settings
have not been determined.
This study will compare intensive counseling plus NRT versus intensive counseling only,
comparing smoking cessation at 2, 6 and 12 months. At 6 months, patients who are still
current smokers will be given a second opportunity to receive their group assigned
intervention, either intensive counseling plus NRT or intensive counseling alone. We will
relate smoking exposure and cessation to HIV progression as measured by immunologic and viral
markers, risk of respiratory infections, including tuberculosis, and AIDS-related
malignancies. The RCT will be performed at the Tshepong HIV Wellness Clinic in Klerksdorp,
South Africa, associated with the Reproductive Health & HIV Research Unit of the University
of the Witwatersrand, South Africa.
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