A prospective study of HIV disease progression in female and male drug users.

Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.

A prospective study of HIV disease progression in female and male drug users.

AIDS. 1999 Feb 4;13(2):257-62. Unique Identifier : AIDSLINE MED/99217482
Webber MP; Schoenbaum EE; Gourevitch MN; Buono D; Klein RS; Department of Epidemiology and Social Medicine, Montefiore; Medical Center and the Albert Einstein College of Medicine,; Bronx, New York 10467, USA.

Abstract: OBJECTIVE: To compare HIV disease progression and mortality in a cohort of female and male drug users. DESIGN: A prospective cohort study of 222 HIV-seropositive women and 302 HIV-seropositive men who attended a hospital-affiliated methadone maintenance program with on-site primary care. METHODS: Regression slopes of CD4+ cell decline were compared using the two sample t-test, and the distribution of AIDS-defining illnesses evaluated by Mantel-Haenszel chi2 test. Time to AIDS-defining clinical conditions and death were compared using the Kaplan-Meier log-rank test. Multivariate estimates of progression to clinical AIDS or death, for all participants, stratified by sex, were derived from Cox proportional hazards models. RESULTS: Ninety-five persons (43 women and 52 men) developed AIDS-defining conditions. Analyses of the rates of CD4+ cell decline, the distribution of first AIDS-defining illnesses, and the time to clinical AIDS did not differ by sex. In the multivariate model, sex was not associated with an AIDS outcome, whereas crack-cocaine use [hazards ratio (HR), 1.815; 95% confidence interval (CI), 1.151-2.863], CD4+ cell count (100 x 10(6)/l; HR, 0.589; 95% CI, 0.511-0.679), and two or more HIV-related symptoms (HR, 1.702; 95% CI, 1.125-2.576) were associated. Mortality rates (8.71 per 100 person-years in women and 9.85 per 100 person-years in men) were similar, using univariate or multivariate methods. CONCLUSIONS: There was little difference in clinical outcomes or mortality between HIV-seropositive female and male drug users with access to primary care. However, crack-cocaine use was independently associated with progression to clinical AIDS.

Keywords: JOURNAL ARTICLE Adult Comparative Study CD4 Lymphocyte Count Disease Progression Female Human HIV Infections/IMMUNOLOGY/*PHYSIOPATHOLOGY Male Prospective Studies *Substance-Related Disorders Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S.
990830
A9981006

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