| Titre : | Effectiveness of highly active antiretroviral therapy among injection drug users with late-stage human immunodeficiency virus infection. (2005) |
| Auteurs : | David Vlahov ; Noya GALAI ; Sandro Galea ; Gregory-D KIRK ; Greg-M Lucas ; Mahboobeh SAFAEIAN ; STERLING (Timothy-R) : USA. Division of Infectious Diseases. Department of Medicine. Vanderbilt University School of Medicine. Nashville. TN. ; Johns Hopkins School of Medicine. Division of Infectious Diseases. Baltimore. MD. USA |
| Type de document : | Article |
| Dans : | American journal of epidemiology (vol. 161, n° 11, 2005) |
| Pagination : | 999-1012 |
| Langues: | Anglais |
| Mots-clés : | Sida ; Virose ; Infection ; Médicament antirétroviral ; Traitement antirétroviral ; Médicament antiviral ; Toxicomanie ; Voie intraveineuse ; Thérapeutique médicamenteuse ; Chimiothérapie ; Thérapeutique ; VIH ; Rétrovirus ; Virus ; Survie ; Pronostic ; Evolution ; Epidémiologie ; Immunopathologie |
| Résumé : | [BDSP. Notice produite par INIST-CNRS aTRR0xfA. Diffusion soumise à autorisation]. Highly active antiretroviral therapy (HAART) has been shown to be effective in different populations, but data among injection drug users are limited. Human immunodeficiency virus-infected injection drug users recruited into the Acquired Immunodeficiency Syndrome Link to Intravenous Experiences (ALIVE) Study as early as 1988 were tested semiannually to identify their first CD4-positive T-lymphocyte cell count below 200/microl ; they were followed for mortality through 2002. Visits were categorized into the pre-HAART (before mid-1996) and the HAART eras and further categorized by HAART use. Survival analysis with staggered entry was used to evaluate the effect of HAART on acquired immunodeficiency syndrome-related mortality, adjusting for other medications and demographic, clinical, and behavioral factors. Among 665 participants, 258 died during 2,402 person-years of follow-up. Compared with survival in the pre-HAART era, survival in the HAART era was shown by multivariate analysis to be improved for both those who did and did not receive HAART (relative hazards=0.06 and 0.33, respectively ; p<0.001). Inferences were unchanged after restricting analyses to data starting with 1993 and considerations of lead-time bias and human immunodeficiency viral load. The annual CD4-positive T-lymphocyte cell decline was less in untreated HAART-era participants than in pre-HAART-era participants (-10/microl vs. - 37/microl, respectively), suggesting that changing indications for treatment may have contributed to improved survival and that analyses restricted to the HAART era probably underestimate HAART effectiveness. |
Service Documentation EHESP
Me connecter
PORTAIL DOCUMENTAIRE
École des hautes études en santé publique
Catalogue
Multi-bases
Accueil
Sélection de la langue
Adresse
Service Documentation EHESPBibliothèque Rennes Avenue du Professeur Léon Bernard – CS 74312 – 35043 Rennes Cedex Bibliothèque MSSH Paris 20 avenue George Sand - 93210 La Plaine Saint-Denis
France
Bibliothèque Rennes : 02 99 02 29 50 Bibliothèque MSSH Paris : 02 99 02 24 50
contact