A poster from Vietnam that showed approximate 20% mortality over one year for HIV-positive people vs 2-3% for HIV-negative.

This prospective cohort study (from August 2005 to July 2007) of 856 male IDUs in Thai Nguyen province, all of whom injected heroin, and 23% were HIV-positive. Median age was 32 (range 18-59).

During 689 person-years of follow up, 43 injectors died (26% were drug overdose deaths). The overall mortality rate was 6% per year, and was significantly higher (p<0.001) among HIV-positive IDUs (14%/year) than among HIV-negatives (4%/year). In multivariate analyses, injecting benzodiazepines in addition to heroin during the 3-month period prior to enrollment increased the hazard of overdose deaths by 4.9 times (95% CI = 1.3-17.9) compared to heroin injection alone.

For non-overdose deaths, IDUs who were HIV-positive at enrollment had a 20% increase in the hazard of deaths (HR = 1.2, 95% CI = 1.1-1.4) compared to HIV-negative IDUs, and a history of tuberculosis increased the hazard by 2.2 times (95% CI = 1.4-3.5).

The study concluded that the observed death rate was high and that IDUs should be informed of the risk of fatal overdose associated with injecting benzodiazepines. Increased access to effective tuberculosis treatment and antiretroviral therapy may help reduce premature deaths among the drug users.

Ref:
Quan VM et al. Premature deaths among Vietnamese injection drug users: predictors and prevention. Abstract MOPO0247.
http://www.aids2008.org/Pag/Abstracts.aspx?AID=9931