The effect of injecting drug use history on disease progression and death among HIV‐positive individuals initiating combination antiretroviral therapy: collaborative cohort analysis
Tóm tắt
We examined whether determinants of disease progression and causes of death differ between injecting drug users (IDUs) and non‐IDUs who initiate combination antiretroviral therapy (cART).
The ART Cohort Collaboration combines data from participating cohort studies on cART‐naïve adults from cART initiation. We used Cox models to estimate hazard ratios for death and AIDS among IDUs and non‐IDUs. The cumulative incidence of specific causes of death was calculated and compared using methods that allow for competing risks.
Data on 6269 IDUs and 37 774 non‐IDUs were analysed. Compared with non‐IDUs, a lower proportion of IDUs initiated cART with a CD4 cell count <200 cells/μL or had a prior diagnosis of AIDS. Mortality rates were higher in IDUs than in non‐IDUs (2.08
While liver‐related deaths and deaths from direct effects of substance abuse appear to explain much of the excess mortality in IDUs, they are at increased risk for many other causes of death, which may relate to suboptimal management of HIV disease in these individuals.
Từ khóa
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