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Crack cocaine, disease progression, and mortality in a multicenter cohort of HIV-1 positive women

Cook, Judith Aa; Burke-Miller, Jane Ka; Cohen, Mardge Hb; Cook, Robert Lc; Vlahov, Davidd; Wilson, Tracey Ee; Golub, Elizabeth Tf; Schwartz, Rebecca Me; Howard, Andrea Ag; Ponath, Claudiah; Plankey, Michael Wi; Levine, Andreaj; Grey, Dennis Da


A typographical error was published in the article ‘Crack cocaine, disease progression, and mortality in a multicenter cohort of HIV-1 positive women.’ by Cook J et al.[1] which appeared on pp. 1355–1363 of AIDS, Volume 22, issue 11.

The twelth author's name appeared as ‘Andrea Levine’ but should have been written ‘Alexandra M. Levine’.

AIDS. 22(14):i, September 12, 2008.

doi: 10.1097/QAD.0b013e32830507f2
Epidemiology and Social

Background: Longitudinal associations between patterns of crack cocaine use and progression of HIV-1 disease are poorly understood, especially among women. This study explores relationships between crack use and HIV-1 disease outcomes in a multicenter cohort of infected women.

Methods: Subjects were 1686 HIV-seropositive women enrolled at six US research centers in the Women's Interagency HIV Study. Approximately 80% were non-white and 29% used crack during the study period. Cox survival and random regression analysis examined biannual observations made April 1996 through September 2004. Outcome measures included death due to AIDS-related causes, CD4 cell count, HIV-1 RNA level, and newly acquired AIDS-defining illnesses.

Results: Persistent crack users were over three times as likely as non-users to die from AIDS-related causes, controlling for use of HAART self-reported at 95% or higher adherence, problem drinking, age, race, income, education, illness duration, study site, and baseline virologic and immunologic indicators. Persistent crack users and intermittent users in active and abstinent phases showed greater CD4 cell loss and higher HIV-1 RNA levels controlling for the same covariates. Persistent and intermittent crack users were more likely than non-users to develop new AIDS-defining illnesses controlling for identical confounds. These results persisted when controlling for heroin use, tobacco smoking, depressive symptoms, hepatitis C virus coinfection, and injection drug use.

Conclusion: Use of crack cocaine independently predicts AIDS-related mortality, immunologic and virologic markers of HIV-1 disease progression, and development of AIDS-defining illnesses among women.

From the aDepartment of Psychiatry, University of Illinois at Chicago, USA

bCore Center and Stroger (formerly Cook County) Hospital, Chicago, Illinois, USA

cCollege of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA

dNew York Academy of Medicine, New York, USA

eDepartment of Preventive Medicine and Community Health, State University of New York Downstate Medical Center, Brooklyn, New York, USA

fDepartment of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, USA

gInternational Center for AIDS Care and Treatment Programs, Mailman School of Public Health, Columbia University, New York, USA

hDepartment of Clinical Pharmacy, University of California at San Francisco, San Francisco, California, USA

iDepartment of Medicine, Georgetown University Medical Center, Washington, District of Columbia, USA

jCity of Hope, Duarte, California, USA.

Received 8 October, 2007

Revised 10 March, 2008

Accepted 16 April, 2008

Correspondence to Judith A. Cook, PhD, Center on Mental Health Services Research and Policy, Department of Psychiatry, University of Illinois at Chicago, 1601 W. Taylor St, 4th Floor M/C912, Chicago, IL 60612, USA. Tel: +1 312 355 3921; fax: +1 312 355 4189; e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.