%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Vu Hai Vinh
%A Vallo, R.
%A Hoang Thi Giang
%A Duong Thi Huong
%A Khuat Thi Hai Oanh
%A Pham Minh Khue
%A Nham Thi Tuyet Thanh
%A Quillet, C.
%A Rapoud, D.
%A Michel, L.
%A Van de Perre, P.
%A Feelemyer, J.
%A Moles, J.P.
%A Cournil, Amandine
%A Des Jarlais, D.
%A Laureillard, D.
%A Nagot, N.
%T A cohort study revealed high mortality among people who inject drugs in Hai Phong, Vietnam
%D 2021
%L fdi:010093137
%G ENG
%J Journal of Clinical Epidemiology
%@ 0895-4356
%K VIET NAM ; HAIPHONG
%M ISI:000703200600005
%P 38-48
%R 10.1016/j.jclinepi.2021.07.007
%U https://www.documentation.ird.fr/hor/fdi:010093137
%> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2025-04/010093137.pdf
%V 139
%W Horizon (IRD)
%X Objective: To estimate the residual mortality rate among people who inject drugs (PWID) in a Low-Middle Income Countries context where the HIV epidemic has been controlled and methadone coverage is high. Study design and setting: PWID from Haiphong, Vietnam, were recruited through three annual respondent-driven sampling surveys that fueled two cohorts of PWID with HIV ( n = 761) and without HIV ( n = 897), with bi-annual follow-up. Presumed causes of death were ascertained from medical records and/or interviews of participants family. Results: Among the 1658 participants with a median follow-up of 2 years, 67 and 36 died in the HIV-positive and HIV-negative cohort, respectively, yielding crude mortality rates of 4.3 (95% Confidence interval (CI): 3.3-5.4) per 100 person-years of follow-up (PYFU) and 1.9 (CI: 1.4-2.6) per 100 PYFU. In the HIV-positive cohort, in which 81% of participants had undetectable viral load, the two main causes of death were tuberculosis and HIV-related diseases. In the HIV-negative cohort, the two main causes of death were liver-related diseases and overdose. In a time-dependent multivariable model, "unsuppressed viral load" was associated with increased risk of mortality, whereas "being on methadone" or "being employed" was associated with a lower risk. Conclusion: Despite a very successful HIV and methadone program, the mortality remains high among PWID in Vietnam, largely due to curable infectious diseases such as tuberculosis and viral hepatitis.
%$ 050MEDECI ; 052MALTRA03