Cause-specific mortality associated with HIV and HTLV-II infections among injecting drug users in the USA.
Cause-specific mortality associated with HIV and HTLV-II infections among injecting drug users in the USA.
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美国注射吸毒者中与 HIV 和 HTLV-II 感染相关的特定原因死亡率。
DOI：
10.1097/00002030-200107060-00012
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发表时间：
2001
期刊：
影响因子：
--
通讯作者：
Engels,EA
中科院分区：
文献类型：
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作者：
Goedert,JJ;Fung,MW;Felton,S;Battjes,RJ;Engels,EA
BackgroundHuman T-lymphotropic virus type II（HTLV-II）广泛存在于注射毒品使用者（IDU）中，并可能导致白血病/淋巴瘤、神经退行性疾病和肺炎，尤其是与HIV合并感染。1998年，他们与国家死亡指数相匹配。观察到的每种原因的死亡人数进行了比较，标准化死亡率与预期的数字，使用性别，种族，年龄和年龄的特定比率在一般人群。相对风险（RR）与每种病毒，相比，未感染的药物users，估计Poisson modeling.ResultsThere死亡，包括683（15%）的4604名参与者谁登记血清阴性两种病毒，328（47%）的701人有艾滋病毒，但没有HTLV-II感染; 1033例HTLV-II但未感染HIV的患者中有220例（21%）; 232例同时感染两种病毒的患者中有120例（52%）。与一般人群相比，两种病毒均未感染的参与者的死亡率增加了4.3倍[95%置信区间（CI），4.0-4.7]，几乎所有死因的死亡率都显著升高。在HIV感染者中，医疗原因而非外部原因导致的死亡率增加了3.7倍（95%CI，3.3-4.2），尤其是在AIDS和相关疾病中。使用HTLV-II，全因死亡率降低（RR，0.8; 95% CI，0.7-0.9），任何特定原因的死亡率均无统计学显著降低或升高。一个非显着过量的结核病死亡（RR，4.6; 95%CI，0.8-25.2）指出，与HTLV-II，但没有过多的死亡率白血病/淋巴瘤，其他恶性肿瘤，或neurodegenerative diseases.ConclusionsWithout HIV或HTLV-II，IDU有深刻的医疗和外部原因的死亡率增加。艾滋病毒与艾滋病和相关疾病引起的死亡特别相关。HTLV-II感染与任何原因的死亡率均无显著相关性，表明即使与HIV感染一起存在，HTLV-II也不是重要的人类病原体。
BackgroundHuman T-lymphotropic virus type II (HTLV-II) is widespread among injecting drug users (IDU) and may contribute to the risk of leukemia/lymphoma, neurodegenerative disease, and perhaps pneumonia, especially with HIV co-infection.MethodsIn 1987–1991, 6570 IDU were tested for HIV and HTLV-II antibodies. In 1998, they were matched to the National Death Index. Numbers of observed deaths of each cause were compared by standardized mortality ratios with the numbers expected, using sex-, race-, age-, and year-specific rates in the general population. Relative risk (RR) associated with each virus, compared to uninfected drug users, was estimated by Poisson modeling.ResultsThere were 1351 deaths, including 683 (15%) of 4604 participants who enrolled seronegative for both viruses; 328 (47%) of 701 who had HIV but not HTLV-II infection; 220 (21%) of 1033 who had HTLV-II but not HIV infection; and 120 (52%) of 232 who were infected by both viruses. Compared to the general population, mortality for participants with neither virus was increased 4.3-fold [95% confidence interval (CI), 4.0–4.7] and was significantly elevated for virtually every cause of death. With HIV, mortality from medical causes, but not external causes, was increased 3.7-fold (95% CI, 3.3–4.2), particularly with AIDS and related conditions. With HTLV-II, all-cause mortality was reduced (RR, 0.8; 95% CI, 0.7–0.9), with no statistically significant reduction or elevation for any specific cause. A non-significant excess of tuberculosis deaths (RR, 4.6; 95% CI, 0.8–25.2) was noted with HTLV-II, but there was no excess mortality from leukemia/lymphoma, other malignancies, or neurodegenerative disease.ConclusionsWithout HIV or HTLV-II, IDU had profoundly increased mortality from medical and external causes. HIV was specifically associated with death due to AIDS and related conditions. HTLV-II infection was not significantly associated with mortality from any cause, suggesting that it is not a significant human pathogen, even when present with HIV infection.