Self-reported antiretroviral therapy in injection drug users
Self-reported antiretroviral therapy in injection drug users
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DOI：
10.1001/jama.280.6.544
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发表时间：
1998-08-12
影响因子：
120.7
通讯作者：
Moore, RD
中科院分区：
文献类型：
--
作者：
Celentano, DD;Vlahov, D;Moore, RD
背景：美国公共卫生服务部门和国际艾滋病协会最近发布了针对人类免疫缺陷病毒 (HIV) 感染者的抗逆转录病毒治疗 (ART) 的建议；然而，轶事证据表明，感染 HIV 的注射吸毒者 (IDU) 可能没有得到建议所定义的最佳护理。 目的。-评估感染 HIV 的 IDU 中 ART 的使用情况。设计。-对 1996 年 7 月至 1997 年 6 月间 IDU 中自我报告的 ART 使用情况进行横断面调查。环境。-巴尔的摩约翰·霍普金斯大学附属的社区诊所， Md.参与者。-1988 年和 1989 年招募了总共 404 名 CD4(+) 细胞计数低于 0.50 x 10(9)/L 的艾滋病毒感染者进行纵向研究。主要结果测量。-评估了自我报告的 ART 使用情况：目前没有治疗、单一治疗或有或没有蛋白酶抑制剂的联合治疗。结果。-一半(199/404 [49%]) 的患者报告近期未接受 ART。总共 14% (58/404) 接受单一疗法，23% (90/404) 接受不使用蛋白酶抑制剂的联合治疗，14% (57/404) 接受使用蛋白酶抑制剂的三联治疗。与 ART 相关因素的多变量分析显示，护理连续性和近期 HIV 相关门诊就诊（比值比 [OR]，4.30；95% 置信区间 [CI]，2.36-7.81 和 OR，2.84；95% CI，1.66-4.88）、CD4(+) 细胞计数低于 0.20 x 10(9)（OR，报告与报告相关，目前未吸毒且正在接受药物治疗（OR，2.16；95% CI，1.34-3.47；OR，2.12；95% CI，1.23-3.66）和失业（OR，2.31；95% CI，1.21-4.40）艺术的使用。在其他分析中，目前注射毒品者（OR，0.5；95% CI，0.3-1.0）和最近被监禁者（OR，0.2；95% CI，0.03-0.9）接受蛋白酶抑制剂的可能性较小，但患有获得性免疫缺陷综合征的患者更有可能接受蛋白酶抑制剂（OR，2.0；95% CI，0.9-4.6）。蛋白酶抑制剂的使用量增加了一倍（P
Context.-The US Public Health Service and the International AIDS Society-USA recently published recommendations for antiretroviral therapy (ART) for persons infected with human immunodeficiency virus (HIV); however, anecdotal evidence suggests that HIV-infected injection drug users (IDUs) may not be receiving optimal care as defined by the recommendations.Objective.-To assess ART use in HIV-infected IDUs.Design.-A cross-sectional survey of self-reported ART use between July 1996 and June 1997 in IDUs.Setting.-A community-based clinic affiliated with Johns Hopkins University, Baltimore, Md.Participants.-A total of 404 HIV-infected IDUs with CD4(+) cell counts less than 0.50 x 10(9)/L recruited into a longitudinal study in 1988 and 1989.Main Outcome Measure.-Self-reported ART use was assessed: no current therapy, monotherapy, or combination therapy with or without a protease inhibitor.Results.-One half (199/404 [49%]) of patients reported no recent ART. A total of 14% (58/404) had monotherapy, 23% (90/404) were receiving combination therapy without a protease inhibitor, and 14% (57/404) had triple-combination therapy with a protease inhibitor. A multivariate analysis of factors associated with ART showed that care continuity and recent HIV-related outpatient visit (odds ratio [OR], 4.30; 95% confidence interval [CI], 2.36-7.81 and OR, 2.84; 95% CI, 1.66-4.88, respectively), CD4(+) cell count of less than 0.20 x 10(9) (OR, 2.41,95% CI, 1.51-3.84), no current drug use and being in drug treatment (OR, 2.16; 95% CI, 1.34-3.47; OR, 2.12; 95% CI, 1.23-3.66, respectively), and unemployment (OR, 2.31;95% CI, 1.21-4.40) were associated with reporting ART use. In other analysis, less likely to receive protease inhibitors were current drug injectors (OR, 0.5; 95% CI, 0.3-1.0) and those recently incarcerated (OR, 0.2; 95% CI, 0.03-0.9), but patients with acquired immunodeficiency syndrome were more likely to receive protease inhibitors (OR, 2.0; 95% CI, 0.9-4.6). Protease inhibitor use doubled (P