HIV treatment outcomes among people who inject drugs in Victoria, Australia

BMC Infectious Diseases

Lisa Maher²  Nick Crofts⁵  John McNeil³  Christopher K Fairley⁴  Handan Wand²  Kerrie Watson⁶  Anne Mijch⁷  Nick Walsh¹ 

[1] Department of Epidemiology and Preventive Medicine, Monash University, 89 Commercial Road, Melbourne 3004, Victoria, Australia;The Kirby Institute, Wallace Wurth Building, UNSW Australia, Sydney 2052, NSW, Australia;School of Public Health and Preventive Medicine, Monash University, 89 Commercial Road, Melbourne 3004, Victoria, Australia;University of Melbourne, Melbourne Sexual Health Centre, Melbourne Sexual Health Centre, 580 Swanston St, Carlton 3053, Victoria, Australia;Nossal Institute for Global Health, 4th Floor, 161 Barry St, Carlton 3010, VIC, Australia;Infection Prevention and Healthcare, Epidemiology Infectious Diseases and Microbiology Unit, Alfred Health, Melbourne 3004, Victoria, Australia;Department of Medicine, Monash University, Clayton 3065, Victoria, Australia

关键词: Australia;    Mortality;    IDU;    PWID;    HIV;   

Others  :  1090415
DOI  :  10.1186/s12879-014-0707-9

 received in 2014-06-26, accepted in 2014-12-11,  发布年份 2014

【 摘 要 】

Background

People who inject drugs (PWID) are a key population affected by HIV. We assessed the effectiveness of HIV treatment among a clinical cohort of people living with HIV (PLHIV) diagnosed and referred for community-based antiretroviral therapy (ART) in Victoria, Australia.

Methods

HIV notification data from a central statewide registry were matched with HIV clinical data from two large HIV treatment centers in Melbourne. We used survival analysis and Cox proportional hazard models to estimate time to AIDS and death for PWID in HIV treatment, compared with non-injectors, in the period 1996 – 2008.

Results

Of the 871 individuals, 93 (10.8%) had injecting as an exposure category and 671 (86%) had ever commenced ART. Adjusted analysis showed younger age, high initial CD4 cell count (>500 cells/mm³) or ever having a CD4 cell count >500/mm³, and more recent calendar year of ART commencement were all associated with reduced hazards for AIDS and death, while older age, low initial CD4 cell count (<200/mm³), ever having a CD4 count <200/mm³ (before or during treatment) and high initial viral load (>5 log₁₀) were associated with increased risk of AIDS and death. PWID were no more likely to experience AIDS (HR 0.98[0.54 – 1.80]) or death (HR 0.78 [0.18 – 3.42]) than non-injectors.

Conclusion

Survival of HIV-infected PWID on HIV treatment was equivalent to non-injectors. CD4 cell count, initial viral load, calendar year of commencing ART and age are more important determinants of AIDS and mortality than injecting status for in-treatment PLHIV in Victoria, Australia.

【 授权许可】

   
2014 Walsh et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

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