A prospective study of HIV disease progression in female and male drug users.

A prospective study of HIV disease progression in female and male drug users.
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女性和男性吸毒者艾滋病毒疾病进展的前瞻性研究。

DOI:
10.1097/00002030-199902040-00014
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发表时间:
1999
期刊:
AIDS (London, England)
影响因子:
--
通讯作者:
Klein,RS
Klein,RS
中科院分区:
--
文献类型:
--
作者:
Webber,MP;Schoenbaum,EE;Gourevitch,MN;Buono,D;Klein,RS

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目的:比较一组男性和女性吸毒者的HIV疾病进展和死亡率。设计:一项前瞻性队列研究,222名hiv血清阳性女性和302名hiv血清阳性男性参加了医院附属的美沙酮维持计划,并进行了现场初级保健。方法:采用两样本t检验比较CD4+细胞下降的回归斜率,采用Mantel-Haenszel χ 2检验评价艾滋病定义疾病的分布。使用Kaplan-Meier对数秩检验比较到艾滋病定义的临床状况和死亡的时间。所有参与者进展为临床艾滋病或死亡的多变量估计,按性别分层,来自Cox比例风险模型。结果:95人(女性43人,男性52人)出现艾滋病定义条件。CD4+细胞下降率的分析,首次艾滋病定义疾病的分布,以及临床艾滋病的时间没有性别差异。在多变量模型中,性别与艾滋病结果无关,而可卡因使用[危险比(HR), 1.815;95%可信区间(CI), 1.151-2.863], CD4+细胞计数(100× 10 6/l; HR, 0.589; 95% CI, 0.511-0.679),以及两种或两种以上hiv相关症状(HR, 1.702; 95% CI, 1.125-2.576)相关。使用单变量或多变量方法,死亡率(女性为8.71 / 100人年,男性为9.85 / 100人年)相似。结论:在获得初级保健的hiv血清阳性女性和男性吸毒者之间,临床结果或死亡率几乎没有差异。然而,快客可卡因的使用与临床艾滋病的进展独立相关。
Objective:To compare HIV disease progression and mortality in a cohort of female and male drug users.Design:A prospective cohort study of 222 HIV-seropositive women and 302 HIV-seropositive men who attended a hospital-affiliated methadone maintenance program with on-site primary care.Methods:Regression slopes of CD4+ cell decline were compared using the two sample t-test, and the distribution of AIDS-defining illnesses evaluated by Mantel-Haenszel χ 2 test. Time to AIDS-defining clinical conditions and death were compared using the Kaplan-Meier log-rank test. Multivariate estimates of progression to clinical AIDS or death, for all participants, stratified by sex, were derived from Cox proportional hazards models.Results:Ninety-five persons (43 women and 52 men) developed AIDS-defining conditions. Analyses of the rates of CD4+ cell decline, the distribution of first AIDS-defining illnesses, and the time to clinical AIDS did not differ by sex. In the multivariate model, sex was not associated with an AIDS outcome, whereas crack-cocaine use [hazards ratio (HR), 1.815; 95% confidence interval (CI), 1.151-2.863], CD4+ cell count (100× 10 6/l; HR, 0.589; 95% CI, 0.511-0.679), and two or more HIV-related symptoms (HR, 1.702; 95% CI, 1.125-2.576) were associated. Mortality rates (8.71 per 100 person-years in women and 9.85 per 100 person-years in men) were similar, using univariate or multivariate methods.Conclusions:There was little difference in clinical outcomes or mortality between HIV-seropositive female and male drug users with access to primary care. However, crack-cocaine use was independently associated with progression to clinical AIDS.
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期刊: AIDS (London)
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