Mortality and HIV Transmission Among Male Vietnamese Injection Drug Users

Overview

Journal Addiction

Specialty Psychiatry

Date 2010 Nov 9

PMID 21054619

Citations 35

Authors

Vu Minh Quan

Nguyen Le Minh

Tran Viet Ha

Nguyen Phuong Ngoc

Pham The Vu

David D Celentano

Tran Thi Mo

Vivian F Go

Affiliations

Soon will be listed here.

Abstract

Aims: To estimate all-cause mortality rate and to assess predictors of all-cause mortality among injection drug users (IDUs) in Thai Nguyen province, Vietnam between 2005 and 2007.

Design: Prospective cohort study.

Setting: Community-dwelling IDUs were enrolled and followed at 3-month intervals for up to 2 years.

Participants: A total of 894 male IDUs (median age of 32 years, 22.8% HIV-positive, all having injected opioids).

Measurements: Deaths were confirmed by family members and by reviewing government records. Marginal Cox proportional hazards models for clustered data were constructed to determine the independent predictors of all-cause mortality, using both fixed baseline measurements and time-dependent repeated measurements.

Findings: During 710.1 person-years of follow-up, 45 (5.0%) drug injectors died. The causes of deaths were AIDS-related (14 cases, 31%), drug overdose (12, 27%), suicide (three, 7%), traffic accident (three, 7%), violence (two, 4%), pneumonia (two, 4%), non-traffic accident (one, 2%) and unknown causes (eight, 18%). The all-cause mortality rate was 6.3% (95% CI = 4.6-8.5) per 100 person-years. The standardized mortality ratio was 13.4. The HIV incidence rate was 5.2 (95% CI = 3.5-7.6) per 100 person-years. In multi-factorial analysis, HIV infection [hazard ratio (HR) = 3.5, 95% CI = 1.9-6.3] and previous diagnosis of tuberculosis (HR = 10.0, 95% CI = 4.1-24.3) were associated significantly with increased hazard of death.

Conclusions: The all-cause, age- and sex-standardized mortality among Vietnamese IDUs is 13-fold higher than the general population and substantially higher than IDUs studied in developed countries. Effective prevention and control of HIV infection and tuberculosis are needed urgently.

Citing Articles

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Low BMI increases all-cause mortality rates in patients with drug-resistant TB.

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A cohort study revealed high mortality among people who inject drugs in Hai Phong, Vietnam.

Vinh V, Vallo R, Thi Giang H, Huong D, Oanh K, Khue P J Clin Epidemiol. 2021; 139:38-48.

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Nguyen M, McNaughton Reyes H, Pence B, Muessig K, Hutton H, Latkin C J Int AIDS Soc. 2021; 24 Suppl 2:e25746.

PMID: 34165258 PMC: 8222856. DOI: 10.1002/jia2.25746.

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