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Impact of injecting drug use on mortality in Danish HIV-infected patients: a nation-wide population-based cohort study.
Addiction. 2010 Mar; 105(3):529-35.A

Abstract

OBJECTIVES

To estimate the impact of injecting drug use (IDU) on mortality in HIV-infected patients in the highly active antiretroviral therapy (HAART) era.

DESIGN

Population-based, nation-wide prospective cohort study in Denmark (the Danish HIV Cohort Study).

METHODS

A total of 4578 HIV-infected patients were followed from 1 January 1997 or date of HIV diagnosis. We calculated mortality rates stratified on IDU. One-, 5- and 10-year survival probabilities were estimated by Kaplan-Meier methods, and Cox regression analyses were used to estimate mortality rate ratios (MRR).

RESULTS

Of the patients, 484 (10.6%) were categorized as IDUs and 4094 (89.4%) as non-IDUs. IDUs were more likely to be women, Caucasian, hepatitis C virus (HCV) co-infected and younger at baseline; 753 patients died during observation (206 IDUs and 547 non-IDUs). The estimated 10-year survival probabilities were 53.2% [95% confidence interval (CI): 48.1-58.3] in the IDU group and 82.1% (95% CI: 80.7-83.6) in the non-IDU group. IDU as route of HIV infection more than tripled the mortality in HIV-infected patients (MRR: 3.2; 95% CI: 2.7-3.8). Adjusting for potential confounders did not change this estimate substantially. The risk of HIV-related death was not increased in IDUs compared to non-IDUs (MRR 1.1; 95% CI 0.7-1.7).

CONCLUSIONS

Although Denmark's health care system is tax paid and antiretroviral therapy is provided free of charge, HIV-infected IDUs still suffer from substantially increased mortality in the HAART era. The increased risk of death seems to be non-HIV-related and is due probably to the well-known risk factors associated with intravenous drug abuse.

Authors+Show Affiliations

Department of Infectious Diseases, Copenhagen University Hospital, DK - 2650 Hvidovre, Denmark. mvlarsen@dadlnet.dkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20402997

Citation

Larsen, Mette V., et al. "Impact of Injecting Drug Use On Mortality in Danish HIV-infected Patients: a Nation-wide Population-based Cohort Study." Addiction (Abingdon, England), vol. 105, no. 3, 2010, pp. 529-35.
Larsen MV, Omland LH, Gerstoft J, et al. Impact of injecting drug use on mortality in Danish HIV-infected patients: a nation-wide population-based cohort study. Addiction. 2010;105(3):529-35.
Larsen, M. V., Omland, L. H., Gerstoft, J., Larsen, C. S., Jensen, J., Obel, N., & Kronborg, G. (2010). Impact of injecting drug use on mortality in Danish HIV-infected patients: a nation-wide population-based cohort study. Addiction (Abingdon, England), 105(3), 529-35. https://doi.org/10.1111/j.1360-0443.2009.02827.x
Larsen MV, et al. Impact of Injecting Drug Use On Mortality in Danish HIV-infected Patients: a Nation-wide Population-based Cohort Study. Addiction. 2010;105(3):529-35. PubMed PMID: 20402997.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of injecting drug use on mortality in Danish HIV-infected patients: a nation-wide population-based cohort study. AU - Larsen,Mette V, AU - Omland,Lars H, AU - Gerstoft,Jan, AU - Larsen,Carsten S, AU - Jensen,Janne, AU - Obel,Niels, AU - Kronborg,Gitte, PY - 2010/4/21/entrez PY - 2010/4/21/pubmed PY - 2010/9/21/medline SP - 529 EP - 35 JF - Addiction (Abingdon, England) JO - Addiction VL - 105 IS - 3 N2 - OBJECTIVES: To estimate the impact of injecting drug use (IDU) on mortality in HIV-infected patients in the highly active antiretroviral therapy (HAART) era. DESIGN: Population-based, nation-wide prospective cohort study in Denmark (the Danish HIV Cohort Study). METHODS: A total of 4578 HIV-infected patients were followed from 1 January 1997 or date of HIV diagnosis. We calculated mortality rates stratified on IDU. One-, 5- and 10-year survival probabilities were estimated by Kaplan-Meier methods, and Cox regression analyses were used to estimate mortality rate ratios (MRR). RESULTS: Of the patients, 484 (10.6%) were categorized as IDUs and 4094 (89.4%) as non-IDUs. IDUs were more likely to be women, Caucasian, hepatitis C virus (HCV) co-infected and younger at baseline; 753 patients died during observation (206 IDUs and 547 non-IDUs). The estimated 10-year survival probabilities were 53.2% [95% confidence interval (CI): 48.1-58.3] in the IDU group and 82.1% (95% CI: 80.7-83.6) in the non-IDU group. IDU as route of HIV infection more than tripled the mortality in HIV-infected patients (MRR: 3.2; 95% CI: 2.7-3.8). Adjusting for potential confounders did not change this estimate substantially. The risk of HIV-related death was not increased in IDUs compared to non-IDUs (MRR 1.1; 95% CI 0.7-1.7). CONCLUSIONS: Although Denmark's health care system is tax paid and antiretroviral therapy is provided free of charge, HIV-infected IDUs still suffer from substantially increased mortality in the HAART era. The increased risk of death seems to be non-HIV-related and is due probably to the well-known risk factors associated with intravenous drug abuse. SN - 1360-0443 UR - https://www.unboundmedicine.com/medline/citation/20402997/Impact_of_injecting_drug_use_on_mortality_in_Danish_HIV_infected_patients:_a_nation_wide_population_based_cohort_study_ L2 - https://doi.org/10.1111/j.1360-0443.2009.02827.x DB - PRIME DP - Unbound Medicine ER -