Hassig S, Kissinger P, Volle J, Kendall C; International Conference on AIDS.
Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. TuPeC3347.
S. Hassig, Tulane University - School of Public Health, 1440 Canal Street, Department of Epidemiology SL-18, United States, Tel.: +1 504 585 6454, Fax: +1 504 988 1568, E-mail: shassig@tulane.edu
Purpose: Substance abuse may hasten HIV disease progression because of poor adherence to or poor metabolism of HIV medication. The purpose of this study was to determine the association of substance abuse and HIV disease progression. Methods: A cohort 108 HIV-infected persons, enrolled on an ongoing NIDA sponsored adherence study, attending a large public HIV outpatient clinic, who were HAART experienced were followed from 9/98 to 12/99. Age, gender, CD4 cell count and self-reported adherence to HIV medication was captured at baseline. Substance use (i.e. alcohol, non-injections and injection drugs) and follow-up CD4 was reported by the provider at each visit. Logistic regression was conducted using SPSS to determine if substance use was associated with a reduction in CD4 cell count. Results: The 108 patients provided 294 visits. Mean baseline CD4/mm3 was 306 (s.d. 227), mean age was 38.7 years (s.d 9.0), 64% were male, 13% were substance users and 63% reported taking at least 95% of their HIV medication as prescribed in the last week. Substance users reported similar adherence at baseline to non-substance users (74% v.s. 66%, P > .35), had similar age, but had lower baseline CD4 count (182 vs 309, P > .02), less months of follow-up times (3.4 vs 4.1, P > .05), and were more likely to be male (84.2 vs 64.8, P > .02). Of the cohort, 23.3% had some reduction in their CD4 cell count from baseline during a mean follow-up of 4.3 months (s.d. 4.1). After adjusting for age, gender, follow-up time, adherence to medication, and baseline CD4 count, substance users were significantly more likely to have CD4 decline than non-substance users (RR 2.74 95% C.I. `1.06-7.12', P > .04). Conclusion: Preliminary results of this cohort study suggest that substance users may have more rapid HIV disease progression. Reasons for this progression (i.e. adherence, medication metabolism, duration of HAART regimen, etc) will be investigated.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Antiretroviral Therapy, Highly Active
- CD4 Lymphocyte Count
- Cohort Studies
- Disease Progression
- HIV Infections
- HIV Seropositivity
- Humans
- Male
- Substance-Related Disorders
Other ID:
UI: 102239307
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