Human immunodeficiency virus infection and infective endocarditis among injecting drug users [see comments]

Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.

Human immunodeficiency virus infection and infective endocarditis among injecting drug users [see comments]

Epidemiology. 1996 Nov;7(6):566-70. Unique Identifier : AIDSLINE MED/97055093
Manoff SB; Vlahov D; Herskowitz A; Solomon L; Munoz A; Cohn S; Willoughby SB; Nelson KE; Department of Epidemiology, Johns Hopkins University School of Hygiene; and Public Health, Baltimore, MD 21205, USA.

Abstract: Human immunodeficiency virus (HIV) infection and infective endocarditis are serious complications of injection drug use. To determine whether HIV infection may increase the risk of endocarditis beyond that associated with drug injection, we performed a nested case-control study among injecting drug users taking part in an ongoing cohort. We identified 26 participants with infective endocarditis between cohort enrollment (in 1988-1989) and June 1992, through reviews of medical records and death certificates. We matched each endocarditis case with up to five controls (N = 120) on enrollment date, race/ethnicity, and follow-up time. Data were taken from baseline and from the one follow-up visit: the last visit before the endocarditis occurred for cases and the closest visit (+/- 3 months) for controls. We used conditional logistic regression to quantify the association between HIV serostatus at follow-up and subsequent endocarditis, after adjusting for a history of endocarditis or sepsis before enrollment, injection duration, current injection frequency, and a recent history of abscess at injection sites. Among current injectors at follow-up, the adjusted odds ratio (OR) of developing endocarditis for HIV-seropositive subjects with > or = 350 CD4 cells per microliter, compared with HIV-seronegative subjects, was 2.31 [95% confidence interval (CI) = 0.61-8.78]; the corresponding OR for HIV-seropositive subjects with < 350 CD4 cells per microliter was 8.31 (95% CI = 1.23-56.37). These data indicate that HIV-related immunodeficiency may independently increase the risk of infective endocarditis among injecting drug users.

Keywords: *Endocarditis/ETIOLOGY *HIV Infections/COMPLICATIONS *Substance Abuse, Intravenous/COMPLICATIONS
Comment in: Epidemiology 1996 Nov;7(6):563-5
970430
M9741585

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