Effectiveness of Highly Active Antiretroviral Therapy among Injection Drug Users with Late-Stage Human Immunodeficiency Virus Infection
dc.contributor.author | Vlahov, David | en_US |
dc.contributor.author | Galai, Noya | en_US |
dc.contributor.author | Safaeian, Mahboobeh | en_US |
dc.contributor.author | Galea, Sandro | en_US |
dc.contributor.author | Kirk, Gregory | en_US |
dc.contributor.author | Lucas, Greg | en_US |
dc.contributor.author | Sterling, Timothy | en_US |
dc.date.accessioned | 2006-07-27T18:51:26Z | |
dc.date.available | 2006-07-27T18:51:26Z | |
dc.date.issued | 2005 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/40266 | |
dc.description.abstract | 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/ll; 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 leadtime 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/microliter vs. -37/microliter, 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. | en_US |
dc.format.extent | 1925 bytes | |
dc.format.extent | 126087 bytes | |
dc.format.mimetype | text/plain | |
dc.format.mimetype | application/pdf | |
dc.language.iso | en_US | en_US |
dc.title | Effectiveness of Highly Active Antiretroviral Therapy among Injection Drug Users with Late-Stage Human Immunodeficiency Virus Infection | en_US |
dc.type | Article | en_US |
dc.subject.hlbsecondlevel | Public Health | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | |
dc.contributor.affiliationum | Epidemiology, Department of | en_US |
dc.contributor.affiliationumcampus | Ann Arbor | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/40266/2/Vlahov_Effectiveness of Highly Active Antiretroviral Therapy_2005.pdf | en_US |
dc.owningcollname | Epidemiology, Department of (SPH) |
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