The relationship between non-injection drug use behaviors on progression to AIDS and death in a cohort of HIV seropositive women in the era of highly active antiretroviral therapy use
The relationship between non-injection drug use behaviors on progression to AIDS and death in a cohort of HIV seropositive women in the era of highly active antiretroviral therapy use
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DOI：
10.1111/j.1360-0443.2005.01098.x
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发表时间：
2005-07-01
期刊：
影响因子：
6
通讯作者：
Vlahov, D
中科院分区：
文献类型：
--
作者：
Kapadia, F;Cook, JA;Vlahov, D
目的评估的纵向模式和类型的非注射药物使用（NIDU）对艾滋病毒进展的影响，在高效抗逆转录病毒疗法（HAART）的时代。设计妇女的跨机构艾滋病毒研究（WIHS），前瞻性队列研究在六个美国sites.Methods数据收集每半年从1994年至2002年对1046 HIV+妇女。多变量考克斯比例风险模型被用来估计相对风险发展艾滋病和死亡的模式和类型的NIDU.Findings在后续行动中，285艾滋病事件和287例死亡，其中177例艾滋病相关，报告。基线时，持续和既往NIDU与CD 4（+）计数< 200个细胞/μ l（分别为43%和46%）和病毒载量> 40 000拷贝/ml（分别为53%和55%）相关。与其他NIDU模式相比，一致的NIDU报告较少使用HAART（53%）。与其他NIDU类型相比，使用兴奋剂与CD 4（+）细胞计数< 200个细胞/μ l（53%）和较低的HAART启动（63%）相关。在多变量分析中，与从未使用者相比，持续（RH = 2.52），不一致（RH = 1.63）和前（RH = 1.56）使用者的艾滋病进展显著更高;与非使用者相比，兴奋剂（RH = 2.04）和多种药物（RH = 1.65）使用者的艾滋病进展显著更高。在多变量分析中，进展为全因死亡仅在前使用者中（RH = 1.48）高于从未使用者。NIDU行为与进展到艾滋病相关death.Conclusions在这项研究中，模式和类型的NIDU与艾滋病毒进展到艾滋病和全因死亡率。这些差异与持续NIDU和使用兴奋剂的HAART使用率较低以及前使用者的基线免疫学和病毒学状态较差有关。
Aims To evaluate the effects of longitudinal patterns and types of non-injection drug use (NIDU) on HIV progression in the highly active antiretroviral therapy (HAART) era.Design Women's Interagency HIV Study (WIHS), a prospective cohort study conducted at six US sites.Methods Data were collected semi-annually from 1994 to 2002 on 1046 HIV+ women. Multivariate Cox proportional hazards modeling was used to estimate relative hazards for developing AIDS and for death by pattern and type of NIDU.Findings During follow-up, 285 AIDS events and 287 deaths, of which 177 were AIDS-related, were reported. At baseline, consistent and former NIDU was associated with CD4(+) counts of < 200 cells/mu l (43% and 46%, respectively) and viral load > 40 000 copies/ml (53% and 55%, respectively). Consistent NIDU reported less HAART use (53%) compared with other NIDU patterns. Stimulant use was associated with CD4(+) cell counts of < 200 cells/mu l (53%) and lower HAART initiation (63%) compared with other NIDU types. In multivariate analyses, progression to AIDS was significantly higher among consistent (RH = 2.52), inconsistent (RH = 1.63) and former (RH = 1.56) users compared with never users; and for stimulant (RH = 2.04) and polydrug (RH = 1.65) users compared with non-users. Progression to all-cause death was higher only among former users (RH = 1.48) compared with never users in multivariate analysis. NIDU behaviors were not associated with progression to AIDS-related death.Conclusions In this study, pattern and type of NIDU were associated with HIV progression to AIDS and all-cause mortality. These differences were associated with lower HAART utilization among consistent NIDU and use of stimulants, and poor baseline immunological and virological status among former users.