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M9480640.TXT
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1994-08-20
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Document 0640
DOCN M9480640
TI High mortality among HIV-infected injecting drug users without AIDS
diagnosis: implications for HIV infection epidemic modellers?
DT 9410
AU van Haastrecht HJ; van den Hoek AJ; Coutinho RA; Municipal Health
Service, Department of Public Health and; Environment, Amsterdam, The
Netherlands.
SO AIDS. 1994 Mar;8(3):363-6. Unique Identifier : AIDSLINE MED/94304558
AB OBJECTIVE: To quantify mortality without AIDS diagnosis (pre-AIDS death)
among HIV-infected injecting drug users (IDU) and to compare it with
that among homosexual men. SETTING: Municipal Health Service in
Amsterdam, The Netherlands. DESIGN: HIV-infected participants of a
cohort of homosexual men (recruited since 1984) and a cohort of IDU
(recruited since 1985) were followed up to investigate the occurrence of
AIDS and pre-AIDS death up to 1 October 1992. Both seroprevalent and
seroconverted participants were included. METHODS: Product-limit
estimates of cumulative AIDS incidence and cumulative pre-AIDS mortality
were calculated for a competing risks model. RESULTS: Of 455
HIV-infected homosexual men, 127 developed AIDS and two died without a
diagnosis of AIDS during follow-up; 31 out of 279 HIV-infected IDU were
diagnosed with AIDS and 33 died without an AIDS diagnosis. After 6.5
years of follow-up an estimated 43.7% of the homosexual men had been
diagnosed with AIDS and 0.7% had died without an AIDS diagnosis, while
32.7% of the IDU had been diagnosed with AIDS and 19.8% had died without
an AIDS diagnosis. CONCLUSIONS: After 6.5 years of follow-up one-fifth
of a group of HIV-infected IDU had died without being diagnosed with
AIDS. This phenomenon seriously limits the number of HIV-infected IDU
that may ever be diagnosed with AIDS and should be considered by HIV
infection epidemic modellers. The new case definitions for AIDS will
limit the number of recorded cases of pre-AIDS death.
DE Acquired Immunodeficiency Syndrome/COMPLICATIONS/DIAGNOSIS/ MORTALITY
Adult Cohort Studies *Disease Outbreaks/STATISTICS & NUMER DATA
Female Follow-Up Studies Human HIV
Infections/*COMPLICATIONS/*MORTALITY Male Middle Age *Models,
Biological Netherlands/EPIDEMIOLOGY Substance Abuse,
Intravenous/*COMPLICATIONS/*MORTALITY JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).