MSF Field Research > 1 Published Research and Commentary > HIV/AIDS > Incidence, risk factors and causes of death in an HIV care programme with a large proportion of injecting drug users.

Please use this identifier to cite or link to this item:     LinkedIn     Citeulike     Connotea     Facebook     Stumble it!

Download this article:
View/Open File Description Size Format
528_Spillane_mort_IDU_12.pdf138KbAdobe PDF

Title: Incidence, risk factors and causes of death in an HIV care programme with a large proportion of injecting drug users.
Authors: Spillane, Heidi
Nicholas, Sarala
Tang, Zhirong
Szumilin, Elisabeth
Balkan, Suna
Pujades-Rodriguez, Mar
Affiliation:  Médecins Sans Frontières, Nanning, China;Epicentre, Paris, France; Guangxi Centre for Disease Control, Nanning, China; Médecins Sans Frontières, Paris, France.
Citation: Trop Med Int Health 2012; Epub ahead of print.
Journal: Tropical Medicine & International Health
Issue Date: 5-Aug-2012
DOI: 10.1111/j.1365-3156.2012.03056.x
PubMed ID: 22863110
Abstract: Objectives  To identify factors influencing mortality in an HIV programme providing care to large numbers of injecting drug users (IDUs) and patients co-infected with hepatitis C (HCV). Methods  A longitudinal analysis of monitoring data from HIV-infected adults who started antiretroviral therapy (ART) between 2003 and 2009 was performed. Mortality and programme attrition rates within 2 years of ART initiation were estimated. Associations with individual-level factors were assessed with multivariable Cox and piece-wise Cox regression. Results  A total of 1671 person-years of follow-up from 1014 individuals was analysed. Thirty-four percent of patients were women and 33% were current or ex-IDUs. 36.2% of patients (90.8% of IDUs) were co-infected with HCV. Two-year all-cause mortality rate was 5.4 per 100 person-years (95% CI, 4.4-6.7). Most HIV-related deaths occurred within 6 months of ART start (36, 67.9%), but only 5 (25.0%) non-HIV-related deaths were recorded during this period. Mortality was higher in older patients (HR = 2.50; 95% CI, 1.42-4.40 for ≥40 compared to 15-29 years), and in those with initial BMI < 18.5 kg/m(2) (HR = 3.38; 95% CI, 1.82-5.32), poor adherence to treatment (HR = 5.13; 95% CI, 2.47-10.65 during the second year of therapy), or low initial CD4 cell count (HR = 4.55; 95% CI, 1.54-13.41 for <100 compared to ≥100 cells/μl). Risk of death was not associated with IDU status (P = 0.38). Conclusion  Increased mortality was associated with late presentation of patients. In this programme, death rates were similar regardless of injection drug exposure, supporting the notion that satisfactory treatment outcomes can be achieved when comprehensive care is provided to these patients.
Type: Article
Language: en
Keywords: Cholera
ISSN: 1365-3156
Rights: Archived on this site with the kind permission of Wiley-Blackwell,
Appears in topics: HIV/AIDS

Related articles on PubMed
The effect of injecting drug use history on disease progression and death among HIV-positive individuals initiating combination antiretroviral therapy: collaborative cohort analysis.
Murray M, Hogg RS, Lima VD, May MT, Moore DM, Abgrall S, Bruyand M, D'Arminio Monforte A, Tural C, Gill MJ, Harris RJ, Reiss P, Justice A, Kirk O, Saag M, Smith CJ, Weber R, Rockstroh J, Khaykin P, Sterne JA, Antiretroviral Therapy Cohort Collaboration (ART-CC)
2012 Feb
Influence of noninjecting and injecting drug use on mortality, retention in the cohort, and antiretroviral therapy, in participants in the Swiss HIV Cohort Study.
Weber R, Huber M, Battegay M, Stähelin C, Castro Batanjer E, Calmy A, Bregenzer A, Bernasconi E, Schoeni-Affolter F, Ledergerber B, Swiss HIV Cohort Study
2015 Mar
Impact of hepatitis C infection on long-term mortality of injecting drug users from 1990 to 2002: differences before and after HAART.
Lumbreras B, Jarrín I, del Amo J, Pérez-Hoyos S, Muga R, García-de la Hera M, Ferreros I, Sanvisens A, Hurtado I, Hernández-Aguado I
2006 Jan 2
Impact of injecting drug use on mortality in Danish HIV-infected patients: a nation-wide population-based cohort study.
Larsen MV, Omland LH, Gerstoft J, Larsen CS, Jensen J, Obel N, Kronborg G
2010 Mar
See all 315 articles

All Items in MSF are protected by copyright, with all rights reserved, unless otherwise indicated.


OR Logo Powered by Open Repository | Cookies


MSF logo MSF Field Research

Aug 31, 2015