Department of Infectious Diseases, Copenhagen University Hospital, DK - 2650 Hvidovre, Denmark.
Addiction. 2010 Mar;105(3):529-35. doi: 10.1111/j.1360-0443.2009.02827.x.
To estimate the impact of injecting drug use (IDU) on mortality in HIV-infected patients in the highly active antiretroviral therapy (HAART) era.
Population-based, nation-wide prospective cohort study in Denmark (the Danish HIV Cohort Study).
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).
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).
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.
评估在高效抗逆转录病毒治疗（HAART）时代，注射吸毒（IDU）对 HIV 感染者死亡率的影响。
基于人群的、全国性的丹麦前瞻性队列研究（丹麦 HIV 队列研究）。
共有 4578 名 HIV 感染者从 1997 年 1 月 1 日或 HIV 诊断日期开始随访。我们按 IDU 进行分层，计算死亡率。通过 Kaplan-Meier 方法估计 1 年、5 年和 10 年的生存率，并用 Cox 回归分析估计死亡率比（MRR）。
患者中，484 例（10.6%）为 IDU，4094 例（89.4%）为非 IDU。IDU 更可能为女性、白种人、丙型肝炎病毒（HCV）合并感染且基线时年龄较小；观察期间有 753 例患者死亡（206 例 IDU 和 547 例非 IDU）。IDU 组 10 年生存率估计为 53.2%（95%可信区间：48.1-58.3），而非 IDU 组为 82.1%（95%可信区间：80.7-83.6）。IDU 作为 HIV 感染途径使 HIV 感染者的死亡率增加了两倍以上（MRR：3.2；95%可信区间：2.7-3.8）。调整潜在混杂因素后，这一估计值没有显著变化。与非 IDU 相比，IDU 发生 HIV 相关死亡的风险并未增加（MRR 1.1；95%可信区间 0.7-1.7）。
尽管丹麦的医疗保健系统是由税收支付的，抗逆转录病毒治疗是免费提供的，但在 HAART 时代，HIV 感染的 IDU 患者的死亡率仍显著增加。死亡风险的增加似乎与 HIV 无关，可能是由于与静脉吸毒相关的已知危险因素所致。
