Tobacco use and nicotine dependence among HIV-infected and uninfected injection drug users.

Introduction: Urban U.S. populations are burdened by intersecting epidemics of HIV infection, injection drug use, and cigarette smoking.

Lung cancer incidence and mortality among HIV-infected and HIV-uninfected injection drug users.

Objectives: To examine the impact of HIV on lung cancer incidence and survival.

Design: : Prospective study of 2495 HIV-infected and HIV-uninfected injection drug users in Baltimore, MD.

Methods: Cancer data were obtained from the Maryland Cancer Registry.

HIV and proteinuria in an injection drug user population.

Background And Objectives: Proteinuria is a major determinant of chronic kidney disease. We aimed to characterize the prevalence and correlates of proteinuria in a cohort of HIV-infected and uninfected injection drug users.

Design, Setting, Participants, & Measurements: A cross-sectional analysis was performed among 902 injection drug users (273 HIV-infected) in the AIDS Linked to the Intravenous Experience cohort.

Prevalence, correlates, and viral dynamics of hepatitis delta among injection drug users.

Background: Most hepatitis delta virus (HDV) prevalence estimates from the United States are >10 years old, and HDV has shown significant temporal variation in other populations. HDV-hepatitis B virus (HBV) dual infection progresses rapidly, has more complications, and has a different treatment regimen than HBV infection alone. Accurate estimates of prevalence and risk factors are important to help clinicians decide who to screen.

HIV and COPD: impact of risk behaviors and diseases on quality of life.

Purpose: Smoking worsens quality of life among HIV-infected individuals, but it remains unclear if this association is related simply to smoking or to chronic obstructive pulmonary disease (COPD), the end-organ disease caused by smoking.

Methods: Using cross-sectional data from the AIDS Linked to the Intravenous Experience study, we determined the independent effects of smoking, HIV and COPD assessed using the Medical Outcome Studies-HIV questionnaire.

Results: Of 973 participants, 287 (29.

Determinants of alcohol consumption in HIV-uninfected injection drug users.

We assess the association between time fixed and time varying participant characteristics and subsequent alcohol consumption in 1968 injection drug users (median age 37 years, 28% female, 90% African-American) followed semi-annually from 1988 to 2008. Median alcohol consumption was seven drinks per week at study entry (first and third quartile: 1, 26) with 36% reporting binge drinking. Alcohol consumption and binge drinking decreased over follow-up.

Cross sectional analysis of respiratory symptoms in an injection drug user cohort: the impact of obstructive lung disease and HIV.

Background: Injection drug use is associated with an increased risk of human immunodeficiency virus (HIV) infection and with obstructive lung diseases (OLD). Understanding how HIV and OLD may impact respiratory symptoms among injection drug users (IDUs) is important to adequately care for this high-risk population. We characterized the independent and joint effects of HIV and OLD on respiratory symptoms of a cohort of inner-city IDUs.

Temporal trends in highly active antiretroviral therapy initiation among injection drug users in Baltimore, Maryland, 1996-2008.

Background: We characterized temporal trends in highly active antiretroviral therapy (HAART) initiation (1996-2008) among treatment-eligible persons in a community-based cohort of current and former injection drug users (IDUs) in Baltimore, Maryland.

Methods: The AIDS Linked to the IntraVenous Experience (ALIVE) cohort has been observing human immunodeficiency virus (HIV)-positive IDUs since 1988. HAART eligibility was defined as the first visit after 1 January 1996 at which the patient's CD4(+) cell count was <350 cells/microL.

Late presentation for human immunodeficiency virus care in the United States and Canada.

BACKGROUND. Initiatives to improve early detection and access to human immunodeficiency virus (HIV) services have increased over time. We assessed the immune status of patients at initial presentation for HIV care from 1997 to 2007 in 13 US and Canadian clinical cohorts.

Large-scale candidate gene analysis of spontaneous clearance of hepatitis C virus.

Human genetic variation is a determinant of recovery from acute hepatitis C virus (HCV) infection; however, to date, single-nucleotide polymorphisms (SNPs) in only a limited number of genes have been studied with respect to HCV clearance. We determined whether SNPs in 112 selected immune response genes are important for HCV clearance, by genotyping 1536 SNPs in a cohort of 343 persons with natural HCV clearance and 547 persons with HCV persistence. PLINK (version 1.

Neighborhood poverty and injection cessation in a sample of injection drug users.

Neighborhood socioeconomic environment may be a determinant of injection drug use cessation. The authors used data from a prospective cohort study of Baltimore City, Maryland, injection drug users assessed between 1990 and 2006. The study examined the relation between living in a poorer neighborhood and the probability of injection cessation among active injectors, independent of individual characteristics and while respecting the temporality of potential confounders, exposure, and outcome.

Multistage genomewide association study identifies a locus at 1q41 associated with rate of HIV-1 disease progression to clinical AIDS.

Background: A mean of 9-10 years of human immunodeficiency virus type 1 (HIV-1) infection elapse before clinical AIDS develops in untreated persons, but this rate of disease progression varies substantially among individuals. To investigate host genetic determinants of the rate of progression to clinical AIDS, we performed a multistage genomewide association study.

Methods: The discovery stage comprised 156 individuals from the Multicenter AIDS Cohort Study, enriched with rapid and long-term nonprogressors to increase statistical power.

HLA-C cell surface expression and control of HIV/AIDS correlate with a variant upstream of HLA-C.

A variant 35 kb upstream of the HLA-C gene (-35C/T) was previously shown to associate with HLA-C mRNA expression level and steady-state plasma HIV RNA levels. We genotyped this variant in 1,698 patients of European ancestry with HIV. Individuals with known seroconversion dates were used for disease progression analysis and those with longitudinal viral load data were used for viral load analysis.

Trends in multidrug treatment failure and subsequent mortality among antiretroviral therapy-experienced patients with HIV infection in North America.

Background: Although combination antiretroviral therapy continues to evolve, with potentially more effective options emerging each year, the ability of therapy to prevent multiple regimen failure and mortality in clinical practice remains poorly defined.

Methods: Sixteen cohorts representing over 60 sites contributed data on all individuals who initiated combination antiretroviral therapy. We identified those individuals who experienced virologic failure (defined as a human immunodeficiency virus [HIV] RNA level >1000 copies/mL), received modified therapy, and subsequently had a second episode of virologic failure.

A meta-analysis of the incidence of non-AIDS cancers in HIV-infected individuals.

Objective: To estimate summary standardized incidence ratios (SIRs) of non-AIDS cancers among HIV-infected individuals compared with general population rates overall and stratified by gender, AIDS, and highly active antiretroviral therapy (HAART) era.

Design: A meta-analysis using SIRs from 18 studies of non-AIDS cancer in HIV-infected individuals.

Methods: SIRs for non-AIDS cancers in HIV-infected individuals and 95% confidence limits (CLs) were abstracted from each study.

Genetic variation in IL28B and spontaneous clearance of hepatitis C virus.

Hepatitis C virus (HCV) infection is the most common blood-borne infection in the United States, with estimates of 4 million HCV-infected individuals in the United States and 170 million worldwide. Most (70-80%) HCV infections persist and about 30% of individuals with persistent infection develop chronic liver disease, including cirrhosis and hepatocellular carcinoma. Epidemiological, viral and host factors have been associated with the differences in HCV clearance or persistence, and studies have demonstrated that a strong host immune response against HCV favours viral clearance.

APOBEC3B deletion and risk of HIV-1 acquisition.

The human APOBEC3 family of cytidine deaminases provides intrinsic immunity to retroviral infection. A naturally occurring 29.5-kb deletion removes the entire APOBEC3B gene.

Effect of cigarette smoking on HIV acquisition, progression, and mortality.

Cigarette smoking is more common among those with HIV compared with the general population. However, it remains unclear whether smoking alters the natural history of HIV infection or if unique health consequences related to smoking occur in the context of HIV. In this article, we review the literature on the effect of smoking on acquisition of HIV, progression of HIV to AIDS, and mortality.

Hepatitis B virus infection and hepatocellular carcinoma among parous Taiwanese women: nationwide cohort study.

Background: Few long-term studies of hepatitis B virus (HBV) infection and hepatocellular carcinoma have focused on women. We used a nationwide cohort of reproductive-aged Taiwanese women to study relationships of HBV infection and parity with hepatocellular carcinoma risk.

Methods: Prenatal test results were available for hepatitis B surface antigen (HBsAg) and e antigen (HBeAg) in the National Hepatitis B Vaccination Registry from 1 782 401 pregnant women tested from October 1, 1983, through March 31, 2000.

Evaluation of human immunodeficiency virus biomarkers: inferences from interval and clinical cohort studies.

Introduction: Among individuals infected with the human immunodeficiency virus (HIV), biomarkers that predict mortality are also used to determine the time when antiretroviral therapy is initiated. No studies have evaluated the impact of the frequency of marker measurements for either their predictive value of mortality or how they may influence inference of the effect of therapy initiation in analyses from observational data.

Methods: We identified 244 persons who were contemporaneously enrolled in both the AIDS Link to the IntraVenous Experience (an interval cohort) and the Johns Hopkins HIV Clinical Cohort between 1995 and 2004.

Effect of early versus deferred antiretroviral therapy for HIV on survival.

Background: The optimal time for the initiation of antiretroviral therapy for asymptomatic patients with human immunodeficiency virus (HIV) infection is uncertain.

Methods: We conducted two parallel analyses involving a total of 17,517 asymptomatic patients with HIV infection in the United States and Canada who received medical care during the period from 1996 through 2005. None of the patients had undergone previous antiretroviral therapy.

Assessment of liver fibrosis by transient elastography in persons with hepatitis C virus infection or HIV-hepatitis C virus coinfection.

Background: Transient elastography is a novel, noninvasive method for staging liver fibrosis. We compared elastography with histologic methods among hepatitis C virus (HCV)-infected and human immunodeficiency virus (HIV)-HCV-coinfected participants in an urban, predominantly black study population.

Methods: Participants recruited from the AIDS Linked to the Intravenous Experience and the Johns Hopkins HIV Clinical Cohort studies underwent elastography to determine liver stiffness measurements.

Nonstructured treatment interruptions among injection drug users in Baltimore, MD.

Background: We characterized patterns of highly active antiretroviral therapy (HAART) use and predictors of nonstructured treatment interruptions (NTIs) among injection drug users (IDUs) in Baltimore, MD.

Methods: Three hundred thirty-five IDUs who initiated HAART from 1996 to 2006 were studied. NTIs were defined as any subsequent 6-month interval where HAART was not reported.