Differences in HIV disease progression by injection drug use and by sex in the era of highly active antiretroviral therapy
作者:
Katharine Poundstone,
Richard Chaisson,
Richard Moore,
期刊:
AIDS
(OVID Available online 2001)
卷期:
Volume 15,
issue 9
页码: 1115-1123
ISSN:0269-9370
年代: 2001
出版商: OVID
关键词: Antiretroviral therapy;HIV progression;injecting drug use;sex
数据来源: OVID
摘要:
BackgroundThe advent of highly active antiretroviral therapy (HAART) has reduced the incidence of most AIDS-related opportunistic illnesses (OI) and death in HIV-infected individuals. We investigated whether there are demographic disparities in HIV disease progression in the HAART era compared with before.MethodsHIV-infected patients in an urban HIV clinical practice in the USA were compared using survival methods for time to a new AIDS-defining OI or death in therapeutic era 1 (monotherapy and combination therapy; 1990–1995; n = 2016) versus era 2 (HAART; 1996–1999; n = 2165).ResultsA total of 1037 (51.4%) events occurred in era 1; 666 (30.8%) events occurred in era 2. In women, the median disease-free survival time increased by 14% (CD4 cell counts > 200 cells/mm3at baseline) and 34% (CD4 cell counts ⩽ 200) in era 2 compared with era 1, whereas for men it increased by 43 and 100%. The relative hazard (RH) of progression for women compared with men in era 2 compared with era 1 was 1.34. For injecting drug use (IDU), disease-free survival time increased by 16% and 34% in era 2 compared with era 1, whereas non-IDU improved by 65 and 135%. The RH of progression for IDU compared with non-IDU in era 2 compared with era 1 was 1.39. No significant differences were detected by race or other HIV transmission risk group.ConclusionDisease-free survival time was extended with the use of HAART, but these gains were not equally distributed by sex and IDU in our cohort.
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