Even though HIV can be well treated these days, drug users are still more cautious about using needles than they used to be. That is the conclusion of Colette Smit following her study into 25 years of HIV in the Netherlands.

Earlier research had shown that since the introduction of the effective HAART therapy, in 1996, homosexual men have more unsafe sex. Smit established that drug users did not exhibit more risky behaviour once the perspective of HIV-infected drug users improved. Due to improved hygiene drug users acquired less HIV and less hepatitis C.

Hepatitis

Smit also examined coinfections. Due to the increased life expectancy relatively more HIV patients have died from other causes in recent years. Infections as a consequence of a reduced immunity (AIDS) remained the number one cause, but the study also revealed an increase in hepatitis and liver-related death. The cause of this was mostly hepatitis C.

Drugs users with both HIV and hepatitis C have a seven times higher chance of dying from liver-related diseases than drug users with just hepatitis C. The side effects of the therapy might also be the cause of the increased chance of liver-related mortality. Patients need to be followed up for longer for definite statements to be made about this.

Smit used data from various studies for her research, some of which were funded by NWO. These studies had mainly been performed in Amsterdam over the past 25 years.

HAART

HAART is the acronym for Highly Active Antiretroviral therapy. This is a combination of various antiviral drugs that suppress the HIV virus. The introduction of HAART in 1996 led to a considerable fall in AIDS mortality. The HAART therapy is not able to cure HIV. However there is a considerable increase in the life expectancy of HIV-infected persons. Nevertheless this remains considerably lower than that of the general population.