Continued drug use and other cofactors for progression to AIDS among injecting drug users.

OBJECTIVE

To evaluate the effects of continued drug use and other cofactors on progression to AIDS among HIV-infected injecting drug users.

DESIGN

A prospective study.

SETTING

The Muirhouse Medical Group in Edinburgh, Scotland, UK.

SUBJECTS

A total of 156 HIV-infected injecting drug users.

MAIN OUTCOME MEASURES

Progression to AIDS and low absolute CD4 counts.

RESULTS

Of this group, 48% will have progressed to AIDS 10 years after seroconversion. Age and low absolute T4 counts had a significant effect on progression to AIDS, with older patients progressing more rapidly. Sex had no significant effects on progression. Absolute CD4+ counts and the CD4:CD8 ratio were significant predictors of progression among the group. Concurrent heroin injecting increased the risk of progression to AIDS. No significant effects were observed for use of other drugs.

CONCLUSIONS

Our findings suggest that continued drug use may have an accelerating effect on progression to AIDS. Age also had an accelerating effect on progression, but sex had no significant effects. In general, the study group did not appear to progress at a different rate from other similar groups of HIV-infected individuals, despite the fact that this was a relatively young cohort. These data were based on accurate estimates of seroconversion dates.