High levels of all-cause mortality among people who inject drugs from 2018 to 2022.

Autor: Roussos S; Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece., Angelopoulos T; Gastroenterology Resident, Gastroenterology Department, G.H.A. Korgialeneio Mpenakeio Hellenic Red Cross, Athens, Greece., Cholongitas E; First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece., Savvanis S; Department of Internal Medicine, General Hospital of Athens 'Elpis', Athens, Greece., Papadopoulos N; 2nd Department of Internal Medicine, 401 General Army Hospital of Athens, Athens, Greece., Kapatais A; 1st Department of Internal Medicine, Western Attica General Hospital 'Agia Varvara', Athens, Greece., Chounta A; 4th Department of Internal Medicine, General University Hospital 'Attikon', Athens, Greece., Ioannidou P; Academic Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, General Hospital of Athens 'Laiko', Athens, Greece., Deutsch M; 2nd Academic Department of Internal Medicine, Hippokration General Hospital, Athens, Greece., Manolakopoulos S; 2nd Academic Department of Internal Medicine, Hippokration General Hospital, Athens, Greece., Sevastianos V; 4th Department of Internal Medicine, Evangelismos General Hospital, Athens, Greece., Papageorgiou MV; Academic Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, General Hospital of Athens 'Laiko', Athens, Greece., Vlachogiannakos I; Academic Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, General Hospital of Athens 'Laiko', Athens, Greece., Mela M; Department of Gastroenterology, Evangelismos General Hospital, Athens, Greece., Elefsiniotis I; Department of Internal Medicine-Hepatogastroenterology, 'Agioi Anargyroi' General and Oncology Hospital, National and Kapodistrian University of Athens, Athens, Greece., Vrakas S; Department of Gastroenterology, Tzaneion General Hospital of Piraeus, Piraeus, Greece., Karagiannakis D; Academic Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, General Hospital of Athens 'Laiko', Athens, Greece., Pliarchopoulou F; 4th Department of Internal Medicine, General University Hospital 'Attikon', Athens, Greece., Chaikalis S; Hellenic Scientific Society for the Study of AIDS, Sexually Transmitted and Emerging Diseases, Athens, Greece., Tsirogianni E; Fourth Department of Internal Medicine, Hippokratio Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece., Psichogiou M; First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece., Kalamitsis G; Hellenic Liver Patient Association 'Prometheus', Athens, Greece., Leobilla F; Municipality of Athens, Greece, Athens, Greece., Paraskevis D; Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece., Malliori M; Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece., Goulis I; Fourth Department of Internal Medicine, Hippokratio Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece., Papatheodoridis G; Academic Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, General Hospital of Athens 'Laiko', Athens, Greece., Hatzakis A; Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Hellenic Scientific Society for the Study of AIDS, Sexually Transmitted and Emerging Diseases, Athens, Greece., Sypsa V; Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: vsipsa@med.uoa.gr.
Jazyk: angličtina
Zdroj: The International journal on drug policy [Int J Drug Policy] 2024 Apr; Vol. 126, pp. 104356. Date of Electronic Publication: 2024 Feb 23.
DOI: 10.1016/j.drugpo.2024.104356
Abstrakt: Background: Mortality among people who inject drugs (PWID) is high, with overdose and HIV infection being the main causes of death. In Greece, there have been no data on mortality, and two HIV outbreaks have been recorded in this population in the past decade. In this study, we aim to estimate the all-cause crude mortality rate and the standardised mortality ratio in this population during 2018-2022.
Methods: PWID recruited from two community-based programs in Athens and Thessaloniki during 2018-2021 were interviewed and tested for HIV/HCV. Data on vital status (deceased/alive) and date of death were obtained from death registries through December 31, 2022. All-cause crude mortality rates (CMR) and standardised mortality ratios (SMR) were estimated. Determinants of mortality were assessed using Cox proportional-hazards model.
Results: Of 2,530 participants, 301 died over 8,543 person-years (PYs) of follow-up. The CMR (95 % CI) was 3.52 (3.15-3.94) deaths per 100 PYs; 3.10 per 100 PYs (2.68-3.58) in Athens and 4.48 per 100 PYs (3.74-5.37) in Thessaloniki. An increasing trend in CMR was identified over 2018-2022 in Athens (from 2.90 to 4.11 per 100 PYs, 41.5 % increase, p = 0.018). The pooled SMR (95 % CI) was 15.86 (14.17-17.76) for both cities and was particularly increased in younger individuals, females, those injecting daily, not enrolled to opioid agonist treatment and HIV-infected individuals. Older age, living in Thessaloniki, Greek origin, homelessness, history of injection in the past 12 months, and HIV infection were independently associated with higher risk of death.
Conclusion: Mortality among PWID in the two largest cities (Athens and Thessaloniki) in Greece in 2018-2022 was high, with the population in Thessaloniki being particularly affected. The increasing trend in mortality in Athens may reflect the long-term impact of the COVID-19 pandemic. Preventive programs such as take-home naloxone, screening and treatment for HIV, are urgently needed.
Competing Interests: Declaration of competing interest N.P. has served as a lecturer for Gilead and AbbVie. S.M. has served as a lecturer/advisor/researcher for Gilead Sciences, Integris, AbbVie, Roche, and Ipsen. IV has served as a lecturer/advisor for Gilead Sciences, Integris Pharma, and Ipsen. Ι.Ε. has served as an advisor/lecturer for Gilead Sciences, Ipsen, Roche and has received unrestricted research grants from Ipsen unrelated to this work. M.P. has a research grant from Gilead Sciences unrelated to this work, and advisory fees from Gilead, GSK, and MSD. G.K. has received grants from Gilead Sciences unrelated to this work. D.P. has received research or travel grants from Gilead Sciences, Glaxo Welcome, and Merck unrelated to this work. Ι.G. has served as an advisor/lecturer for Gilead Sciences, Ipsen, Roche, Integris Pharma, and has received unrestricted research grants from Ipsen unrelated to this work. G.P. has served as an advisor/lecturer for Albireo, Amgen, Genesis, Gilead Sciences, GlaxoSmithKline, Ipsen, Janssen, Novo Nordisk, Roche, Takeda and has received research grants from Gilead Sciences unrelated to this work. AHatzakis has received unrestricted grants from AbbVie, Gilead, and MSD unrelated to this work. He is Co-Chair of the Hepatitis B & C Public Policy Association funded by AbbVie, Gilead, and MSD. VSypsa has received a grant from Gilead Sciences for the submitted work. She has received grants from Gilead and AbbVie unrelated to this work. She has served as a lecturer for Gilead and AbbVie. S.R., T.A., E.C., S.S., A.K., AChounta, P.I., M.D., VSevastianos, M.V.P., S.V., D.K., F.P., S.C., E.T., F.L., MMalliori, and MMela have nothing to declare.
(Copyright © 2024. Published by Elsevier B.V.)
Databáze: MEDLINE
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