Influence of noninjecting and injecting drug use on mortality, retention in the cohort, and antiretroviral therapy, in participants in the Swiss HIV Cohort Study

HIV Medicine - Tập 16 Số 3 - Trang 137-151 - 2015
Rainer Weber1, Michael Huber1, Manuel Battegay2, Cornelia Stähelin3, Erika Castro Batänjer4, Alexandra Calmy5, Andrea Bregenzer6, Enos Bernasconi7, Franziska Schoeni-Affolter8, Bruno Ledergerber1
1Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
2Division of Infectious Diseases, Department of Internal Medicine, University Hospital, Basel, Switzerland
3Division of Infectious Diseases, University Hospital and University of Bern, Bern, Switzerland
4St-Martin Addiction Medicine Center, Service of Community Psychiatry, University Hospital, Centre hospitalier universitaire vaudois, Lausanne, Switzerland
5Division of Infectious Diseases University Hospital Hôpitaux Universitaires de Genève Geneva Switzerland
6Division of Infectious Diseases and Hospital Epidemiology, Department of Internal Medicine, Cantonal Hospital, St. Gallen, Switzerland
7Division of Infectious Diseases, Department of Internal Medicine, Ospedale Regionale, Lugano, Switzerland
8Swiss HIV Cohort Study Data Center, University Hospital and University of Lausanne, Lausanne, Switzerland

Tóm tắt

ObjectivesWe studied the influence of noninjecting and injecting drug use on mortality, dropout rate, and the course of antiretroviral therapy (ART), in the Swiss HIV Cohort Study (SHCS).MethodsCohort participants, registered prior to April 2007 and with at least one drug use questionnaire completed until May 2013, were categorized according to their self‐reported drug use behaviour. The probabilities of death and dropout were separately analysed using multivariable competing risks proportional hazards regression models with mutual correction for the other endpoint. Furthermore, we describe the influence of drug use on the course of ART.ResultsA total of 6529 participants (including 31% women) were followed during 31 215 person‐years; 5.1% participants died; 10.5% were lost to follow‐up. Among persons with homosexual or heterosexual HIV transmission, noninjecting drug use was associated with higher all‐cause mortality [subhazard rate (SHR) 1.73; 95% confidence interval (CI) 1.07–2.83], compared with no drug use. Also, mortality was increased among former injecting drug users (IDUs) who reported noninjecting drug use (SHR 2.34; 95% CI 1.49–3.69). Noninjecting drug use was associated with higher dropout rates. The mean proportion of time with suppressed viral replication was 82.2% in all participants, irrespective of ART status, and 91.2% in those on ART. Drug use lowered adherence, and increased rates of ART change and ART interruptions. Virological failure on ART was more frequent in participants who reported concomitant drug injections while on opiate substitution, and in current IDUs, but not among noninjecting drug users.ConclusionsNoninjecting drug use and injecting drug use are modifiable risks for death, and they lower retention in a cohort and complicate ART.

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Tài liệu tham khảo

10.1097/QAD.0b013e32835221cc

10.1016/S0140-6736(11)61138-0

10.1001/jama.2013.13805

The United Nations Office on Drugs and Crime: World Drug Report 2013

Conen A, 2009, Self‐reported alcohol consumption and its association with adherence and outcome of antiretroviral therapy in the Swiss HIV Cohort Study, Antivir Ther, 14, 349, 10.1177/135965350901400303

10.1097/QAI.0b013e3182a61ea9

10.1016/j.jsat.2011.01.001

10.1097/00002030-199009000-00006

Peterson PK, 1991, Cocaine potentiates HIV‐1 replication in human peripheral blood mononuclear cell cocultures. Involvement of transforming growth factor‐beta, J Immunol, 146, 81, 10.4049/jimmunol.146.1.81

10.1007/978-1-4615-2980-4_4

10.1016/S0165-5728(97)00227-0

10.1016/S0165-5728(97)00226-9

10.1007/s11481-006-9023-5

10.1097/00002030-200411050-00018

10.1097/00002030-199204000-00010

10.1097/00042560-199903010-00010

10.1097/00002030-199705000-00010

10.1097/QAI.0b013e3181900129

Bassetti S, 1999, Why is highly active antiretroviral therapy (HAART) not prescribed or discontinued? Swiss HIV Cohort Study, J Acquir Immune Defic Syndr, 21, 114

10.1093/ije/dyp321

Glass TR, 2008, Self‐reported non‐adherence to antiretroviral therapy repeatedly assessed by two questions predicts treatment failure in virologically suppressed patients, Antivir Ther, 13, 77, 10.1177/135965350801300108

10.1097/EDE.0b013e31821b5332

10.1111/j.1468-1293.2012.01051.x

10.1080/01621459.1999.10474144

10.1093/aje/kwj059

10.1001/jama.285.11.1466

10.1016/S0002-9343(02)01169-5

Anastos K, 2005, The association of race, sociodemographic, and behavioral characteristics with response to highly active antiretroviral therapy in women, J Acquir Immune Defic Syndr, 39, 537

10.2105/AJPH.94.7.1133

10.1086/433175

10.1097/QAD.0b013e32830507f2

10.1097/01.qai.0000127354.78706.5d

10.1086/428121

10.1016/j.drugalcdep.2007.11.010

10.1089/aid.2008.0196

10.1007/s10552-008-9258-y

Des Jarlais DC, 1987, Development of AIDS, HIV seroconversion, and potential co‐factors for T4 cell loss in a cohort of intravenous drug users, AIDS, 1, 105

10.1056/NEJM199509213331202

10.1136/bmj.301.6765.1362

10.1097/00042560-200107010-00006

10.1097/01.aids.0000202651.41397.db

10.1097/QAD.0b013e328133f285

10.1093/ije/dyp306

10.1111/j.1468-1293.2009.00701.x

10.1093/cid/cit207

10.1186/1742-5573-1-4

10.1097/EDE.0b013e3181a819a1

10.1007/s00038-010-0160-5

The Swiss Federal Statistical Office.Mortality causes of death: data indicators. Available athttp://www.bfs.admin.ch/bfs/portal/en/index/themen/14/02/04/key/01.html(accessed 11 August 2013).

10.1111/j.1360-0443.1993.tb02058.x

10.1016/j.addbeh.2013.05.015

10.3109/10826088109039193

10.3109/10826084.2011.640732

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HIV Medicine

Tập 16 Số 3

137-151

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