Death after diagnosis of noncommunicable disease comorbid conditions, stratified by injection drug use

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Abstract

OBJECTIVE: Describe all-cause mortality associated with history of injection drug use (IDU) after a validated diagnosis of four noncommunicable disease (NCD) diagnoses: end-stage liver disease (ESLD); end-stage renal disease (ESRD); cancer; or myocardial infarction (MI) or stroke. DESIGN: We followed four cohorts of persons in continuity HIV care in the Johns Hopkins HIV Clinic with a validated diagnosis of ESLD (n = 67), ESRD (n = 187), cancer (n = 424), and MI or stroke (n = 213) from 1996 through approximately 2014. METHODS: Crude and adjusted Cox proportional hazards models to estimate hazard ratios for death after a validated diagnosis of one of four NCD diagnoses associated with history of IDU as an HIV acquisition risk factor. RESULTS: History of IDU was not associated with death after ESRD (adjusted hazard ratio 0.98, 95% confidence interval (CI) 0.57-1.68). Associations between history of IDU and death after ESLD and MI or stroke were weak, imprecise and not statistically significant (hazard ratio 1.17, 95% CI 0.63-2.19; hazard ratio 1.21, 95% CI 0.80-1.83). History of IDU was not associated with death after cancer in the first 6 months, but subsequently, the adjusted hazard ratio was 2.03 (95% CI 1.26-3.27). CONCLUSION: Persons with a history of injection drug use and non-IDU had strikingly similar risk and hazard of mortality after several major NCD diagnoses. Mortality after cancer diagnosis in this cohort was higher for persons with a history of IDU than those without; this may be because of being diagnosed with a different mix of specific sites and stages of cancers.

Original languageEnglish (US)
Pages (from-to)285-293
Number of pages9
JournalAIDS (London, England)
Volume33
Issue number2
DOIs
StatePublished - Feb 1 2019

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Injections
Pharmaceutical Preparations
End Stage Liver Disease
Confidence Intervals
Chronic Kidney Failure
Stroke
Myocardial Infarction
HIV
Neoplasms
Mortality
Continuity of Patient Care
Proportional Hazards Models

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

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title = "Death after diagnosis of noncommunicable disease comorbid conditions, stratified by injection drug use",
abstract = "OBJECTIVE: Describe all-cause mortality associated with history of injection drug use (IDU) after a validated diagnosis of four noncommunicable disease (NCD) diagnoses: end-stage liver disease (ESLD); end-stage renal disease (ESRD); cancer; or myocardial infarction (MI) or stroke. DESIGN: We followed four cohorts of persons in continuity HIV care in the Johns Hopkins HIV Clinic with a validated diagnosis of ESLD (n = 67), ESRD (n = 187), cancer (n = 424), and MI or stroke (n = 213) from 1996 through approximately 2014. METHODS: Crude and adjusted Cox proportional hazards models to estimate hazard ratios for death after a validated diagnosis of one of four NCD diagnoses associated with history of IDU as an HIV acquisition risk factor. RESULTS: History of IDU was not associated with death after ESRD (adjusted hazard ratio 0.98, 95{\%} confidence interval (CI) 0.57-1.68). Associations between history of IDU and death after ESLD and MI or stroke were weak, imprecise and not statistically significant (hazard ratio 1.17, 95{\%} CI 0.63-2.19; hazard ratio 1.21, 95{\%} CI 0.80-1.83). History of IDU was not associated with death after cancer in the first 6 months, but subsequently, the adjusted hazard ratio was 2.03 (95{\%} CI 1.26-3.27). CONCLUSION: Persons with a history of injection drug use and non-IDU had strikingly similar risk and hazard of mortality after several major NCD diagnoses. Mortality after cancer diagnosis in this cohort was higher for persons with a history of IDU than those without; this may be because of being diagnosed with a different mix of specific sites and stages of cancers.",
author = "Catherine Lesko and Lau, {Bryan M} and Geetanjali Chander and Moore, {Richard D}",
year = "2019",
month = "2",
day = "1",
doi = "10.1097/QAD.0000000000002054",
language = "English (US)",
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TY - JOUR

T1 - Death after diagnosis of noncommunicable disease comorbid conditions, stratified by injection drug use

AU - Lesko, Catherine

AU - Lau, Bryan M

AU - Chander, Geetanjali

AU - Moore, Richard D

PY - 2019/2/1

Y1 - 2019/2/1

N2 - OBJECTIVE: Describe all-cause mortality associated with history of injection drug use (IDU) after a validated diagnosis of four noncommunicable disease (NCD) diagnoses: end-stage liver disease (ESLD); end-stage renal disease (ESRD); cancer; or myocardial infarction (MI) or stroke. DESIGN: We followed four cohorts of persons in continuity HIV care in the Johns Hopkins HIV Clinic with a validated diagnosis of ESLD (n = 67), ESRD (n = 187), cancer (n = 424), and MI or stroke (n = 213) from 1996 through approximately 2014. METHODS: Crude and adjusted Cox proportional hazards models to estimate hazard ratios for death after a validated diagnosis of one of four NCD diagnoses associated with history of IDU as an HIV acquisition risk factor. RESULTS: History of IDU was not associated with death after ESRD (adjusted hazard ratio 0.98, 95% confidence interval (CI) 0.57-1.68). Associations between history of IDU and death after ESLD and MI or stroke were weak, imprecise and not statistically significant (hazard ratio 1.17, 95% CI 0.63-2.19; hazard ratio 1.21, 95% CI 0.80-1.83). History of IDU was not associated with death after cancer in the first 6 months, but subsequently, the adjusted hazard ratio was 2.03 (95% CI 1.26-3.27). CONCLUSION: Persons with a history of injection drug use and non-IDU had strikingly similar risk and hazard of mortality after several major NCD diagnoses. Mortality after cancer diagnosis in this cohort was higher for persons with a history of IDU than those without; this may be because of being diagnosed with a different mix of specific sites and stages of cancers.

AB - OBJECTIVE: Describe all-cause mortality associated with history of injection drug use (IDU) after a validated diagnosis of four noncommunicable disease (NCD) diagnoses: end-stage liver disease (ESLD); end-stage renal disease (ESRD); cancer; or myocardial infarction (MI) or stroke. DESIGN: We followed four cohorts of persons in continuity HIV care in the Johns Hopkins HIV Clinic with a validated diagnosis of ESLD (n = 67), ESRD (n = 187), cancer (n = 424), and MI or stroke (n = 213) from 1996 through approximately 2014. METHODS: Crude and adjusted Cox proportional hazards models to estimate hazard ratios for death after a validated diagnosis of one of four NCD diagnoses associated with history of IDU as an HIV acquisition risk factor. RESULTS: History of IDU was not associated with death after ESRD (adjusted hazard ratio 0.98, 95% confidence interval (CI) 0.57-1.68). Associations between history of IDU and death after ESLD and MI or stroke were weak, imprecise and not statistically significant (hazard ratio 1.17, 95% CI 0.63-2.19; hazard ratio 1.21, 95% CI 0.80-1.83). History of IDU was not associated with death after cancer in the first 6 months, but subsequently, the adjusted hazard ratio was 2.03 (95% CI 1.26-3.27). CONCLUSION: Persons with a history of injection drug use and non-IDU had strikingly similar risk and hazard of mortality after several major NCD diagnoses. Mortality after cancer diagnosis in this cohort was higher for persons with a history of IDU than those without; this may be because of being diagnosed with a different mix of specific sites and stages of cancers.

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U2 - 10.1097/QAD.0000000000002054

DO - 10.1097/QAD.0000000000002054

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AN - SCOPUS:85058897144

VL - 33

SP - 285

EP - 293

JO - AIDS

JF - AIDS

SN - 0269-9370

IS - 2

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