Spijkerman I J, Langendam M W, Veugelers P J, van Ameijden E J, Keet I P, Geskus R B, van den Hoek A, Coutinho R A
Municipal Health Service, Department of Public Health and Environment, Amsterdam, The Netherlands.
Epidemiology. 1996 Nov;7(6):571-7. doi: 10.1097/00001648-199611000-00002.
We compared rates of progression to AIDS for 99 injection drug users and 120 homosexual men with documented dates of HIV-1 seroconversion. The crude risk of developing AIDS was higher among homosexual men than injection drug users [relative hazard (RH) = 2.4; 95% confidence interval (CI) = 1.3-4.4]. The relative hazard was slightly smaller among participants with a seroconversion interval of < or = 1 year (RH = 2.2; 95% CI = 1.0-5.2). The effect was partially explained by the inclusion of Kaposi's sarcoma in the AIDS case definition. Excluding those with Kaposi's sarcoma, the relative hazard was 2.0 (95% CI = 1.1-3.8). Using the 1993 AIDS case definition decreased the effect (RH = 1.9; 95% CI = 1.1-3.4). Finally, the high pre-AIDS mortality among injection drug users could partially explain the difference in progression rate between injection drug users and homosexual men. Combining the effect of the above-mentioned factors resulted in a relative hazard of 1.3 (95% CI = 0.7-2.6). Thus, the slower progression to AIDS among injection drug users compared with homosexual men was largely explained by differences in the spectrum of AIDS-defining illnesses, pre-AIDS mortality, and length of seroconversion interval.
我们比较了99名注射吸毒者和120名有记录的HIV-1血清转化日期的同性恋男性发展为艾滋病的进展率。同性恋男性中患艾滋病的粗略风险高于注射吸毒者[相对风险（RH）=2.4；95%置信区间（CI）=1.3 - 4.4]。在血清转化间隔≤1年的参与者中，相对风险略小（RH = 2.2；95% CI = 1.0 - 5.2）。这种影响部分是由于艾滋病病例定义中纳入了卡波西肉瘤。排除患有卡波西肉瘤的患者后，相对风险为2.0（95% CI = 1.1 - 3.8）。采用1993年艾滋病病例定义降低了这种影响（RH = 1.9；95% CI = 1.1 - 3.4）。最后，注射吸毒者中艾滋病前期的高死亡率可以部分解释注射吸毒者和同性恋男性之间进展率的差异。综合上述因素的影响，相对风险为1.3（95% CI = 0.7 - 2.6）。因此，与同性恋男性相比，注射吸毒者发展为艾滋病的进展较慢在很大程度上是由艾滋病定义疾病谱、艾滋病前期死亡率和血清转化间隔时间的差异所解释的。
