Crack cocaine, disease progression, and mortality in a multicenter cohort of HIV-1 positive women
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Author
Cook, Judith ABurke-Miller, Jane K
Cohen, Mardge H
Cook, Robert L
Vlahov, David
Wilson, Tracey E
Golub, Elizabeth T
Schwartz, Rebecca M
Howard, Andrea A
Ponath, Claudia
Plankey, Michael W
Levine, Andrea
Grey, Dennis D
Journal title
AIDSDate Published
2008-07-11Publication Volume
22Publication Issue
11Publication Begin page
1355Publication End page
1363
Metadata
Show full item recordAbstract
Background: Longitudinal associations between patterns of crack cocaine use and progression of HIV-1 disease are poorly understood, especially among women. This study explores relationships between crack use and HIV-1 disease outcomes in a multicenter cohort of infected women. Methods: Subjects were 1686 HIV-seropositive women enrolled at six US research centers in the Women's Interagency HIV Study. Approximately 80% were non-white and 29% used crack during the study period. Cox survival and random regression analysis examined biannual observations made April 1996 through September 2004. Outcome measures included death due to AIDS-related causes, CD4 cell count, HIV-1 RNA level, and newly acquired AIDS-defining illnesses. Results: Persistent crack users were over three times as likely as non-users to die from AIDS-related causes, controlling for use of HAART self-reported at 95% or higher adherence, problem drinking, age, race, income, education, illness duration, study site, and baseline virologic and immunologic indicators. Persistent crack users and intermittent users in active and abstinent phases showed greater CD4 cell loss and higher HIV-1 RNA levels controlling for the same covariates. Persistent and intermittent crack users were more likely than non-users to develop new AIDS-defining illnesses controlling for identical confounds. These results persisted when controlling for heroin use, tobacco smoking, depressive symptoms, hepatitis C virus coinfection, and injection drug use. Conclusion: Use of crack cocaine independently predicts AIDS-related mortality, immunologic and virologic markers of HIV-1 disease progression, and development of AIDS-defining illnesses among women.Citation
Cook JA, Burke-Miller JK, Cohen MH, Cook RL, Vlahov D, Wilson TE, Golub ET, Schwartz RM, Howard AA, Ponath C, Plankey MW, Levine AM, Grey DD. Crack cocaine, disease progression, and mortality in a multicenter cohort of HIV-1 positive women. AIDS. 2008 Jul 11;22(11):1355-63. doi: 10.1097/QAD.0b013e32830507f2. Erratum in: AIDS. 2008 Sep 12;22(14):i. Levine, Andrea [corrected to Levine, Alexandra M]. PMID: 18580615; PMCID: PMC2645902.DOI
10.1097/qad.0b013e32830507f2ae974a485f413a2113503eed53cd6c53
10.1097/qad.0b013e32830507f2
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- Creative Commons
Except where otherwise noted, this item's license is described as Attribution-NonCommercial-NoDerivatives 4.0 International
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