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Patients with drug-abuse poisoning with and without HIV infection: differential characteristics

Losada A, Supervía A, Vallecillo G, Petrus C, Aranda D, Chen J, Saubi N, Pallàs O, Perelló R

Emergency Department, Hospital Clínic, Barcelona, Spain. Emergency Department, Hospital del Mar, Barcelona, Spain. Addiction Unit, Hospital del Mar, Parc de Salut Mar Consortium, Barcelona, Spain.

Objective. Persons with HIV infection who use illicit drugs have higher morbidity and mortality rates than nonusers with or without HIV infection. The objetive were to detect differences between acute poisoning from illicit drugs in patients with and without HIV infection who are attended in hospital emergency departments, and to identify independent factors associated with a worse prognosis, defined by hospital admission or death.
Methods. Observational study in 2 hospitals between January 2017 and 31 December 2021. Included were patients with acute illicit drug poisoning with and without HIV infection.
Results. Information for 1132 patients was included. The mean (SD) ages of patients with and without HIV infection, respectively, were 38.9 (9.6) years and 32.6 (10.4) years. In patients with HIV, the main drugs used were opioids (279 [85.3%]), cocaine (226 [69.1%]), and amphetamines (153 [46.8%]. None in this group were on methadone substitution therapy for opioid addiction. In patients without HIV infection the main drugs were cocaine (372 [47.2%]) and cannabis (238 [33.8%]). Alcohol was used along with illicit drugs in 387 cases. Multivariate analysis showed that the only variables independently associated with a poor prognosis were HIV infection (odds ratio [OR], 2.19 [1.29-3.11], P < .003), age (OR, 1.20 [1.01-1.05], P < .003), and acute poisoning from benzodiazepines (OR, 3.48 [2.14-5.66], P < .001). The area under the receiver operating characteristic curve of the model was 0.717.
Conclusion. Certain characteristics distinguish the illicit drug use of patients with HIV infection. HIV infection, age, and the use of benzodiazepines are independently associated with a poor prognosis in acute poisonings.

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