title: Five year outcomes of a cohort of HIV-infected injection drug users in a primary care practice.
abstract: Overall mortality related to HIV infection has declined with the advent of highly active anti-retroviral therapy (HAART). The purpose of this study was to examine the five-year outcomes of a cohort of 175 consecutive patients with HIV infection and injection drug use followed at a primary care practice. Patients were seen for their first visit between June 1994 and May 1998. At five years from their initial visit, 53 patients (30.3%) had died, while 47 (26.9%) were still active patients in our primary care practice. Of those who died, HIV was the cause of death in a little over half of patients (55%) followed by liver disease (15%) and drug overdose (11%). Only 80 patients ever received highly active anti-retroviral therapy (HAART) and 52 (65%) of these achieved an undetectable viral load. Patients who never received HAART had a five-year mortality of 34.8%, compared to 25.0% in patients who ever received HAART, p < .001. Our data underscore the high burden of morbidity and mortality associated with HIV infection among IDUs despite the availability of effective treatment.
authors.affiliation: Division of Chemical Dependence, Department of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD 21224, USA. mfingerho@jhmi.edu
authors.forename: Michael
authors.initials: M
authors.lastname: Fingerhood
authors.forename: Darius A
authors.initials: DA
authors.lastname: Rastegar
authors.forename: Donald
authors.initials: D
authors.lastname: Jasinski
mesh_terms: D000046:Academic Medical Centers; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000401:mortality*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015142:Baltimore; D018791:CD4 Lymphocyte Count; D002423:Cause of Death; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D015819:Substance Abuse, Intravenous / Q000401:mortality*; D016896:Treatment Outcome; D019562:Viral Load