Methadone maintenance treatment modalities in relation to incidence of HIV: results of the Amsterdam cohort study
Methadone maintenance treatment modalities in relation to incidence of HIV: results of the Amsterdam cohort study
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DOI：
10.1097/00002030-199909100-00015
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发表时间：
1999-09-10
期刊：
影响因子：
3.8
通讯作者：
van Ameijden, EJC
中科院分区：
文献类型：
--
作者：
Langendam, MW;van Brussel, GHA;van Ameijden, EJC
研究目的：评价美沙酮维持治疗方式，规定在减少危害的概念，在吸毒者与美沙酮治疗的历史在阿姆斯特丹，Netherlands.Design：前瞻性观察队列研究582艾滋病毒阴性吸毒者之间的艾滋病毒感染的发病率。为了确保有效和详细的评估美沙酮治疗，数据从中央美沙酮登记在阿姆斯特丹被链接到阿姆斯特丹队列研究中的吸毒者。方法：泊松回归分析被用来确定独立和显着的预测发病率的HIV。主要结果：在1 906人年期间，58名吸毒者发生血清转化，艾滋病毒总发病率为每100人年3.0人，目前注射者的发病率呈下降趋势。在多变量分析中，接受美沙酮治疗的频率增加[相对危险度（RR），2.4; 95%可信区间（CI），1.2-4.6，与无变化相比]和美沙酮剂量增加（RR，0.8; 95% CI，0.6-1.0，每类变化10 mg/天）与HIV发病率显著相关。美沙酮剂量和频率的方案出席本身并没有显着的预测。其他多变量显着的危险因素是无家可归，目前注射和住院病人的医院care.Conclusions：在吸毒者中接受美沙酮维持治疗的危害减少设置，其中包括辅助服务，如针交换方案和艾滋病毒检测和咨询，处方的美沙酮高剂量是不足以阻止艾滋病毒的传播。然而，个别增加美沙酮剂量和采取措施以实现较高的治疗保留率可有助于预防吸毒者中的艾滋病毒。(C)1999年利平科特威廉姆斯&威尔金斯。
Study objective: To evaluate methadone maintenance treatment modalities, prescribed within the concept of harm reduction, in relation to incidence of HIV infection among drug users with a history of methadone treatment in Amsterdam, The Netherlands.Design: Prospective observational cohort-study among 582 HIV-negative drug users. To ensure valid and detailed assessment of methadone treatment, data from the Central Methadone Register in Amsterdam were linked to the Amsterdam cohort study among drug users.Methods: Poisson regression analysis was used to identify independent and significant predictors of incidence of HIV.Main results: During 1906 person years, 58 drug users seroconverted, the overall incidence of HIV being 3.0 per 100 person years with a declining trend for current injectors. An increase in frequency of methadone programme attendance [relative risk (RR), 2.4; 95% confidence interval (CI), 1.2-4.6, compared with no change] and increase in methadone dosage (RR, 0.8; 95% Cl, 0.6-1.0, per category of change of 10 mg/day) were significantly associated with incidence of HIV in multivariate analysis. Methadone dosage and frequency of programme attendance in itself were not significant predictors. Other multivariate significant risk factors were homelessness, current injecting and in-patient hospital care.Conclusions: Among drug users who receive methadone maintenance treatment in a harm-reduction setting, which includes ancillary services such as needle-exchange programmes and HIV testing and counselling, prescription of high methadone dosages is not sufficient to stop the spread of HIV. However, an individual increase of the methadone dosage and measures to achieve high treatment retention could contribute to the prevention of HIV among drug users. (C) 1999 Lippincott Williams & Wilkins.