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Do HIV Disease Progression and HAART Response Vary among Injecting Drug Users in Europe?

  • Infectious Diseases
  • Published:
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Abstract

Prior to HAART availability, there was no evidence of a geographical variation in HIV disease progression among injecting drug users (IDU) from different European regions. Nowadays, factors of importance regarding HIV disease progression in the face of HAART availability, such as HAART access, adherence, and the organization of care for IDU may differ across Europe. Therefore we studied HIV disease progression in a European study of IDU with known dates of HIV-seroconversion. Results show that with ongoing HAART availability, the risk of HIV disease progression has continued to decrease. When accounting for pre-AIDS death (in AIDS analyses) and non-natural deaths (suicide, overdose, accidents and homicide, in analyses of death) which are common among IDU, the risk of AIDS and death has decreased by as much as 65% and 75%, respectively, in 2000/2001. Results show little geographic variation in progression to AIDS. All-cause mortality was higher in IDU from Glasgow than elsewhere, while in the Valencian region (Spain) IDU were at a significantly lower risk of non-natural deaths. The timing of HAART initiation by treatment-naïve IDU likewise differed across Europe: IDU in Amsterdam, Innsbruck, and Edinburgh started at significantly lower CD4 counts than IDU in Paris, Geneva, Glasgow, and the Valencian region, but the subsequent short-term immune response was similar. In conclusion, the risk in progression to AIDS or natural death is similar across western Europe although IDU across Europe differ in other factors, such as the risk of non-natural death and the timing of HAART initiation.

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Authors and Affiliations

  1. Municipal Health Service, Cluster Infectious Diseases, Amsterdam, The Netherlands

    Liselotte van Asten, Roel A. Coutinho & Maria Prins

  2. AIDS Unit, University of Innsbruck, Innsbruck, Austria

    Robert Zangerle

  3. On behalf of the Valencian HIV Seroconversion Study, Department of Public Health, Miguel Hernandez University, Alicante, Spain

    Ildefonso Hernández Aguado

  4. SEROCO study group, Inserm U 292, Hôpital de Bicêtre, Le Kremlin Bicêtre, France

    Faroudy Boufassa

  5. Division of Infectious Diseases, Geneva University Hospital, Geneva, Switzerland

    Barbara Broers

  6. Infectious Diseases Unit, Western General Hospital, Edinburgh, UK

    Raymond P. Brettle

  7. Edinburgh Drug Addiction Study, Muirhouse Medical Group, Edinburgh, UK

    J. Roy Robertson

  8. Scottish Center for Infection and Environmental Health, Glasgow, Scotland

    Jim McMenamin

  9. Department of Human Retrovirology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands

    Roel A. Coutinho

  10. Department for Infectious Diseases Epidemiology (CIE), RIVM, National Institute for Public Health and the Environment, Bilthoven, The Netherlands

    Liselotte van Asten

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  1. Liselotte van Asten
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  2. Robert Zangerle
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  3. Ildefonso Hernández Aguado
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  4. Faroudy Boufassa
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  6. Raymond P. Brettle
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  7. J. Roy Robertson
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  10. Maria Prins
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Correspondence to Liselotte van Asten.

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van Asten, L., Zangerle, R., Hernández Aguado, I. et al. Do HIV Disease Progression and HAART Response Vary among Injecting Drug Users in Europe?. Eur J Epidemiol 20, 795–804 (2005). https://doi.org/10.1007/s10654-005-1049-0

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