Degenhardt L, Hall W, Warner-Smith M
National Drug and Alcohol Research Centre, University of New South Wales, Sydney NSW 2052, Australia.
Sex Transm Infect. 2006 Jun;82 Suppl 3(Suppl 3):iii56-63. doi: 10.1136/sti.2005.019273.
Injecting drug use (IDU) and associated mortality appear to be increasing in many parts of the world. IDU is an important factor in HIV transmission. In estimating AIDS mortality attributable to IDU, it is important to take account of premature mortality rates from other causes to ensure that AIDS related mortality among injecting drug users (IDUs) is not overestimated. The current review provides estimates of the excess non-AIDS mortality among IDUs.
Searches were conducted with Medline, PsycINFO, and the Web of Science. The authors also searched reference lists of identified papers and an earlier literature review by English et al (1995). Crude mortality rates (CMRs) were derived from data on the number of deaths, period of follow up, and number of participants. In estimating the all-cause mortality, two rates were calculated: one that included all cohort studies identified in the search, and one that only included studies that reported on AIDS deaths in their cohort. This provided lower and upper mortality rates, respectively.
The current paper derived weighted mortality rates based upon cohort studies that included 179 885 participants, 1,219,422 person-years of observation, and 16,593 deaths. The weighted crude AIDS mortality rate from studies that reported AIDS deaths was approximately 0.78% per annum. The median estimated non-AIDS mortality rate was 1.08% per annum.
Illicit drug users have a greatly increased risk of premature death and mortality due to AIDS forms a significant part of that increased risk; it is, however, only part of that risk. Future work needs to examine mortality rates among IDUs in developing countries, and collect data on the relation between HIV and increased mortality due to all causes among this group.
在世界许多地区，注射吸毒及相关死亡率似乎正在上升。注射吸毒是艾滋病毒传播的一个重要因素。在估计因注射吸毒导致的艾滋病死亡率时，考虑其他原因导致的过早死亡率很重要，以确保注射吸毒者中与艾滋病相关的死亡率不会被高估。本综述提供了注射吸毒者中非艾滋病额外死亡率的估计。
通过医学数据库（Medline）、心理学文摘数据库（PsycINFO）和科学引文索引（Web of Science）进行检索。作者还检索了已识别论文的参考文献列表以及English等人（1995年）的早期文献综述。粗死亡率（CMR）来自死亡人数、随访期和参与者人数的数据。在估计全因死亡率时，计算了两个比率：一个包括检索中识别出的所有队列研究，另一个只包括在其队列中报告艾滋病死亡情况的研究。这分别提供了较低和较高的死亡率。
本文基于队列研究得出加权死亡率，这些队列研究包括179885名参与者、1219422人年的观察期和16593例死亡。报告艾滋病死亡情况的研究中加权粗艾滋病死亡率约为每年0.78%。估计的非艾滋病死亡率中位数为每年1.08%。
非法药物使用者过早死亡的风险大幅增加，艾滋病导致的死亡率是该增加风险的重要组成部分；然而，这只是该风险的一部分。未来的工作需要研究发展中国家注射吸毒者的死亡率，并收集关于艾滋病毒与该群体中所有原因导致的死亡率增加之间关系的数据。
