Epidemiology

To determine the effect of HIV infection and other factors on infective endocarditis among IVDU Wilson et al. [36] examined the incidence of endocarditis according to HIV status in a cohort of IVDU. Endocarditis incidence (117 cases) was higher among HIV-seropositive than HIV-seronegative IVDU (13.8 vs. 3.3 cases/1,000 person-years). Multivariate analysis of HIV-infected case patients revealed an inverse association between infective endocarditis and CD4 lymphocyte count (OR for 200-499 cells/mm3, 2.01, OR for <200 cells/mm3, 3.61) and with alcohol intake (OR for 1-21 drinks/week, 0.43; OR for > 21 drinks/week, 0.32). Women had an increased risk of endocarditis (OR, 3.26), as did persons with increasing injection drug use frequency (OR for less than daily use, 3.15; OR for at least daily use, 6.07) (see Figure 3.3). This study confirmed that infective endocarditis is more common among IVDU with advanced HIV immunosuppression even after accounting for injection drug use behaviors. The higher incidence found in woman is surprising as in other populations including IVDU without HIV a higher incidence is found consistently in men. Conversely, infective endocarditis in HIV-infected persons who do not use drugs is rare. In

Figure 3.3. Cumulative hazard of first episode of infective endocarditis over time, by HIV serostatus [36].

Figure 3.3. Cumulative hazard of first episode of infective endocarditis over time, by HIV serostatus [36].

the absence of intravenous drug abuse, HIVseropositive patients develop left-sided and right-sided infective endocarditis with equal frequencies. In contrast, in the setting of intravenous drug abuse, HIV-seropositive patients develop predominantly right-sided infective endocarditis. The related morbidity and mortality rates in HIV-seropositive patients who do not have an AIDS-defining illness or criteria are similar to rates in HIV-seronegative counterparts [37,38].

Beat The Battle With The Bottle

Beat The Battle With The Bottle

Alcoholism is something that can't be formed in easy terms. Alcoholism as a whole refers to the circumstance whereby there's an obsession in man to keep ingesting beverages with alcohol content which is injurious to health. The circumstance of alcoholism doesn't let the person addicted have any command over ingestion despite being cognizant of the damaging consequences ensuing from it.

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