TABLE 2.

Summary of reviewed studies

Article	Location	Cohort	Recruitment and follow-up	Sample	Drug use	HIV treatment	Outcome
Page et al., 1996 [53]	Miami, Florida, United States		Community-recruited from non-treatment settings, 1987–1988; followed-up until 1995	116 current IDU, 32 (28%) female, 108 (93%) black, 80 (69%) aged 30–40 years	48 (41%) at least daily heroin	14 (12%) exposed to AZT	Time to death (all-cause)
Brown et al., 1996 [27]	New York City, New York, United States		Recruited from 6 methadone maintenance clinics, 1988 – 1991; followed-up until 1993	328 heterosexuals with history of IDU, 202 (62%) male, 191 (58%) African American, 186 (57%) age 30–39	165 (50%) injection drugs in previous 3 months, 122 (37%) injection heroin in last three month	Proportion exposed to zidovudine and PCP prophylaxis not reported	Time to death (all-cause)
German AIDS Study Group [37]	Germany		Recruited from 20 HIV/AIDS treatment centres, 1982 – 1993	1554 IDU, 59% male, average age 31 years	Not reported	All exposed to antiretrovirals, 88% zidovudine	Time to death (all-cause)
Brettle et al., 1996 [26]	Edinburgh, Scotland	Edinburgh City Hospital cohort	Recruited from hospital, 1985 – 1994	260 IDU estimated to have seroconverted between 1983 and 1985, 180 (69%) male, 188 (72%) < 25 years	Not reported	Proportion exposed to zidovudine not reported	Time to death (all-cause); time to AIDS [CDC 1987 definition]; time to CDC IV [CDC 1986 definition]
Crum et al., 1996 [30]	Baltimore, Maryland, United States	AIDS Link to the Intravenous Experience (ALIVE)	Recruited from community settings, 1988 – 1989	188 IDU seroconverting ± 1 year from November 1993, 74% men, 92% African-American	35% > 10 years injection history at baseline; 16% no injection in last six months	29% zidovudine use	Change in CD4+%, change in CD8+%
Hershow et al., 1996 [39]	Chicago, Illinois; Baltimore, Maryland; Bronx, New York; Rome, Italy	AIDS Outreach Intervention Project (Chicago); ALIVE (Baltimore); Bronx HERO (Bronx); Italian Seroconversion Study (Rome)	Recruited from community and treatment settings	370 IDU with incident HIV infection, 27% female, mean age 32 years at seroconversion	Not reported	23% ever exposed to zidovudine	Time to death from AIDS-defining condition; time to AIDS [CDC 1987]
Ferrando et al., 1996 [33]	San Francisco, California, United States		Recruited at MMT clinic in 1991	57 IDU on MMT and zidovudine treatment, 42% female, 52% Caucasian	60% cocaine dependence, 36% alcohol dependence, 11% amphetamine dependence	100% exposed to zidovudine	CD4+ cell count change
Montella et al., 1997 [49]	Rome, Italy	Italian Seroconversion Study	Recruited from hospital setting, 1985 – 1991; followed prospectively to 1993	549 IDU seroconverting 1985 – 1991, 140 female,	100% history of heroin injection	Not reported	Time to AIDS [CDC 1987]
Prins et al., 1997 [63]	Spain, Scotland, Netherlands, Switzerland, France, Austria	European Seroconverter Study	Recruited from community and treatment settings, 1982 – 1988;	664 IDU with documented seroconversion, 221 (33%) female, mean age 25 years at seroconversion	Not reported	Not reported	Time to death, pre-AIDS
Radkowski et al., 1997 [65]	Poland		Recruited from methadone clinic (cases) and detoxification ward (controls)	56 IDU, 73% female	Not reported	Not reported	Change in CD4+ cell counts
Lyles et al., 1997 [45]	Baltimore, Maryland, United States	ALIVE	Recruited from community settings, 1988 – 1989	605 IDU recruited before 1993, 78% male, 97% African American	71% current user, 33% inject < 1 day	Not reported	Difference in CD4+ cell count pairs
Baum et al., 1997 [24]	Miami, Florida, United States		Community recruited from non-treatment settings, 1987–1988; followed-up until 1995	125 IDU, 34% women, 88% African American	77% positive urine screen for cocaine use during study	Proportion exposed to zidovudine not reported	Time to death, HIV-related causes
Marmor et al., 1997 [46]	New York City, New York, United States		Recruited from hospital-based methadone programme, 1990 –1991, followed until 1993	133 IDU, 78% male, 47% Hispanic	11 (9%) = 1 injection/day; 78 (61%) < 1 injection/day	Not reported	Time to death (all-cause)
Vlahov et al., 1998 [73]	Baltimore, Maryland, United States	ALIVE	Recruited from community settings, 1988 – 1989; followed until 1996	522 IDU with incidence seroconversion, 80% male, 96% African-American	Not reported	6% on zidovudine at baseline; 47% exposed to monotherapy during follow-up	Time to death (infectious disease-related); time to AIDS diagnosis
Haydon et al., 1998 [38]	Edinburgh, Scotland	Edinburgh IDU cohort	Recruitment from clinical settings, 1985 onwards	240 IDU with known HCV serostatus, 163 (68%) male,	Not reported	Not reported	Time to death (all-cause); time to CDC Stage IV [undefined definition date] and time to AIDS [CDC 1997 definition]
Zhang et al., 1998 [77]	Baltimore, Maryland, United States	ALIVE	Recruited from community settings, 1988 – 1989	170 IDU, 31 (17%) women, 6 (3%)	156 (89%) current IDU	Not reported	CD4+ cell count
Webber et al., 1998 [74]	New York City, New York, United States	Bronx HERO	Recruited from clinic-based methadone treatment programme, 1985, followed until 1997	524 IDU, 42% female, 64% Hispanic	Approximately 77% reported any injection at each follow-up	Approximately 60% exposed to zidovudine; 80% exposed to PCP prophylaxis	Time to AIDS-defining condition [CDC 1993 definition]
Farzadegan et al., 1998 [32]	Baltimore, Maryland, United States	ALIVE	Recruited from community settings, 1988 – 1989 and 1992 – 1993, followed until 1996	812 IDU, 24% female, 96% African American	80% current drug use at baseline	10% zidovudine use in the previous six months at baseline	Time to AIDS [CDC 1993 definition]
Webber et al., 1999 [75]	New York City, New York, United States	Bronx HERO	Recruited from clinic-based methadone treatment programme, 1985, followed until 1997	524 IDU, 302 (58%) male, 63% Hispanic	93% self-reported illicit drug use during follow-up, 77% self-reported injection	Proportion exposed to zidovudine at baseline and during follow-up not reported	Time to AIDS [CDC 1993 definition]
Pezzotti et al., 1999 [58]	Baltimore, Maryland, United States and Italy	ALIVE and ISS	Community and hospital recruitment	1003 IDU with estimated seroconversion 1988 – 1996, 28% female, 77% non-black	21% > 10 years injection career;	Not reported	Time to AIDS [CDC 1993 definition], time to death (infectious-disease related)
Krol et al., 1999 [43]	Baltimore, Maryland, United States and Amsterdam, Netherland	ALIVE and the Amsterdam Cohort Study among Drug Users	Community-recruited	287 IDU with estimated seroconversion date, 72% male, 73% non-White	81% self-report injection drug use; 37% cocaine injectors	Not reported	Decline in CD4+ cell counts
Schinkel et al., 1999 [67]	Amsterdam, Netherlands	Amsterdam Cohort Study Among Drug Users	Recruited from 1985 until 1997	108 IDU with incidence seroconversions, 60% male, 89% White race	Not reported	Not reported	Time to AIDS [CDC 1987 and 1993 definitions], time to death (all-cause), time to CD4+ cell count < 200
Carrieri et al., 1999 [28]	Marseille, Nice and Paris, France	MANIF	Recruited from clinical settings, October 1995 – October 1996	108 IDU, 34% female, average 33 years old	39% injected morphine/heroin in previous six months at baseline, 25% in maintenance therapy	Not reported	HIV-1 RNA viral load
Prazuck et al., 1999 [61]	Villeneuve-Saint-Georges, France		Recruited from HIV clinical service, 1991 – 1996; followed for 481 months	12 IDU, 100% male	100% active IDU	4 (33%) ever exposed to zidovudine	Differences in CD4+ cell count
Prins et al., 1999 [62]	Spain, Scotland, Netherlands, Switzerland, France, Austria	European Seroconverter Study	Recruitment from community and clinical settings, 1982 – 1988; followed until 1995	664 IDU, 221 (33%) female	Not reported	Not reported	Time to death (AIDS-related); time to immunosuppression; time to AIDS [CDC 1987 definition
Piketty et al., 1999 [59]	Paris, France		Recruited from clinic setting, 1989 – 1992; followed until 1996	124 IDU, 91 (73%) male	68% reported daily injection at baseline; 57% reported daily injecting at study end	35% received antiretroviral therapy during follow-up	Time to AIDS-defining event [CDC, 1992]; time to death (all-cause)
Shor-Posner et al., 2000 [68]	Miami, Florida, United States	Miami HIV-1-Infected Drug Abusers Cohorts (MIDAS)	Recruited from community clinic and followed from 1992 – 1996	125 IDU, 66% male, 89% African-American	50% positive for poly-drug use by urine toxicology; 55% self-report daily use of illicit drugs	8% ART-exposed	Time to death (all-cause)
Ajello et al., 2000 [20]	Unreported		Recruitment setting and method unreported; study period 1993 – 1995	21 non-IDU non-HIV; 47 HIV-seronegative IDU and 101 HIV-seropositive IDU	Not reported	Not reported	Difference in CD4+ cell count
Carrieri et al., 2000 [29]	Paris, Nice and Marseille, France	MANIF	Recruited from clinical settings, October 1995 – October 1996, followed until 1998	103 HAART-treated patients, 20 on buprenorphine and 83 ex-IDU	Not reported	All participants initiated HAART at baseline; adherence not reported	Difference in plasma HIV RNA load
Prins et al., 2000 [64]	Amsterdam, Netherlands and London, England	Amsterdam Cohort Studies on HIV Infection and AIDS; Royal Free Hospital cohort	Recruited from clinical settings prior to December, 1985; followed until January 1, 1998	111 men with haemophilia; 118 IDU; 158 men who have sex with men; all with well-estimated seroconversion date	Not reported	Not reported	Time to death (pre-AIDS); time to AIDS
Pradier et al., 2001 [60]	Paris, Nice and Marseille, France	MANIF	Recruited from clinical settings, October 1995 – October 1996, followed until 1998	119 IDU prescribed HAART with complete adherence evaluation, 65% male	5.9% active IDU at baseline	All prescribed HAART; 28.6% < 100% adherence during follow-up	Change in plasma HIV RNA load; change in CD4+ cell count
Moreno et al., 2001 [50]	Madrid, Spain		Recruited from specialist clinical setting and followed-up from October 1996 – October 1998	54 (26.0%) IDU on methadone and 154 (74%) IDU not on methadone; all prescribe HAART	10 (18%) in methadone group reported illicit drug use during follow-up	All prescribed HAART; 63% had > 90% adherence during study	Changes in plasma HI RNA load; change in CD4+ cell count
Barber et al., 2001 [22]	Lleida, Catalonia, Spain	Lleida AIDS Cohort	Recruited from specialist clinical setting and followed-up until March 1999	185 IDU with seroconversion date between 1982 and 1991; 100% Caucasian, 75% male	Not reported	154 (74.0%) received ART at some point during study	Time to AIDS [CDC 1987] and time to AIDS [CDC 1993]
Zaccarelli et al., 2002 [76]	Rome, Italy		Recruited from outpatient clinic and followed-up from October 1998 – December 1999	80 IDU; 58 (72.5%) male, mean age 37	20% reported active injection drug use	100% treated with combination antiretroviral therapy	Time to virologic failure defined as two observations > 500 copies/mL
Arnsten et al., 2002 [21]	Bronx, New York City, New York	HERO	Recruited from substance abuse treatment clinic and followed-up from July 1998 to April 2000	80 IDU on antiretroviral therapy 51 (60%) male, 19 (23%) African American	32 (38%) self-reported heroin or cocaine use during study	100% on ART; 59 (69%) had regimens including a protease inhibitor	Plasma HIV RNA suppression
Perez-Hoyos et al., 2003 [57]	Valencia and Barcelona, Spain	GEMES	Recruited from clinical settings and followed until January 2000	830 IDU with well-estimated seroconversion dates in the 1980s	Not reported	Approximately one-third accessed ART during study period	Time to AIDS; time to death (all-cause)
Golub et al., 2003 [36]	Baltimore, Maryland, United States	ALIVE	Recruited from community settings; followed-up until December, 1999	451 IDU without AIDS diagnosis [CDC 1993]; 76.3% men, 95.8% African-American	Not reported	Not reported	Time to AIDS [CDC 1993]; time to death (all-cause)
Palepu et al., 2003a [56]	Vancouver, Canada	Drug Treatment Programme	Recruited from treatment registry and followed-up until December, 2000	174 IDU on HAART	Not reported	Not reported	Likelihood of plasma HIV RNA suppression
Palepu et al., 2003b [54]	Vancouver, Canada	Barriers to antiretroviral therapy (BART)	Recruited from community settings and followed-up from May 1996 to July 2001	234 IDU on HAART; 38.0% female	65% injected heroin and/or cocaine daily over study period	100% initiated HAART at baseline	Likelihood of plasma HIV RNA suppression
van Asten et al., 2003 [71]	Valencia, Spain; Edinburgh, Scotland; Amsterdam, Netherlands; Geneva, Switzerland; Glasgow, Scotland; Paris, France; Innsbruck, Austria	European Seroconverter Study	Recruited from clinical settings from 1982 to 1988 and followed until January 1998	751 IDU with well-estimated date of seroconversion; 33% female, median age 26 years at seroconversion	Not reported	Not reported	Time to AIDS [CDC 1993 definition]
Nguyen et al., 2004 [51]	Bangkok, Thailand		Recruited from drug treatment settings between 1995 – 1998	130 IDU with incident seroconversion; mean age 31 years, 89.2% male	Not reported	Not reported	Time to CD4+ cell count < 200 cells
de la Hera et al., 2004 [35]	Valencia and Barcelona, Spain	GEMES	Recruited from clinical settings and followed until March 2001	929 IDU with well-estimated seroconversion dates; 24.7% women	Not reported	337 (36.3%) prescribed HAART during study	Time to AIDS; time to death (all-cause)
van Asten and Prins, 2004 [69]	Valencia, Spain; Edinburgh, Scotland; Amsterdam, Netherlands; Geneva, Switzerland; Glasgow, Scotland; Paris, France; Innsbruck, Austria	European Seroconverter Study and Italian Seroconverter Study	Recruited from clinical settings from 1982 to 1988 and followed until January 1998	126 IDU co-infected with hepatitis C; 40 (32%) female	Not reported	75% had exposure to HAART by the end of the study period	Time to AIDS; time to death (pre-AIDS)
van Asten et al., 2005 [70]	Valencia, Spain; Edinburgh, Scotland; Amsterdam, Netherlands; Geneva, Switzerland; Glasgow, Scotland; Paris, France; Innsbruck, Austria	European Seroconverter Study	Recruited from clinical settings from 1982 to 1988 and followed until January 2002	790 IDU with well-estimated date of seroconversion, 68% male	Not reported	227 (42.8%) in the HAART era exposed to HAART	Time to AIDS; time to all-cause death
Galai et al., 2005 [34]	Baltimore, Maryland, United States	ALIVE	Recruited from community settings and followed-up until December, 2000	1030 IDU with CD4+ cell counts < 500 cells	Approximately 30% inject > 1 time/day	Approximately 5% exposed to HAART	Time to death (HIV related)
Bouhnik et al., 2005 [25]	Paris, Nice and Marseille, France	MANIF 2000	Recruited from clinical settings and followed until 2000	243 IDU initiating HAART with CD4+ cell count > 200 cells	17% active injectors at baseline	All initiated HAART	Time to death (AIDS-related) or CD4+ cell count < 200 cells
Vlahov et al., 2005 [72]	Baltimore, Maryland, United States	ALIVE	Recruited from community settings and followed until December 2002	665 IDU with CD4+ cell count < 200 cells; 94.6% Black, 74.6% male	63.7% injected illicit drugs during study	62.1% ever exposed to HAART during study	Time to death (HIV-related)
Kohli et al., 2005 [42]	Bronx, New York City, New York, United States	HERO	Recruited from methadone treatment clinics from 1996 to 2001	398 IDU, 237 (59.5%) male, 267 (67.1%) Hispanic	185 (46.5%) any illicit drug use in previous six months at baseline	165 (46.4%) exposed to HAART at baseline	Time to death (all-cause)
Knowlton et al., 2006 [40]	Baltimore, Maryland; Miami, Florida; New York City, New York; San Francisco, California, United States	Interventions for Seropositive Injectors — Research and Evaluation (INSPIRE)	Recruited from community settings and followed up from 2000 to 2004	1113 IDU on HAART; 156 (34%) female, 315 (69%) non-Hispanic black	432 (91%) self-report illicit drug use	All on HAART; 42% self-reported taking prescribed medications	Likelihood of HIV RNA viral load suppression
Palepu et al., 2006 [55]	Vancouver, Canada	BART	Recruited from community settings and followed-up from May 1996 to November 2004	278 IDU on HAART; 160 (57.6%) male	Approximately 50% self-reported daily cocaine injection at baseline	All on HAART; 129 (46.4%) =95% adherent by pharmacy refill at baseline	Likelihood of HIV RNA viral load suppression
Duncan et al., 2007 [31]	Miami, Florida, United States		Recruited from community settings	80 individuals, 100% self-reported crack cocaine smoking; 100% African-American women	Participants self-reported approximately 22 days of crack use in previous month	None exposed to treatment at recruitment	Change in CD4+ cell counts
Mehta et al., 2007 [47]	Baltimore, Maryland, United States	ALIVE	Recruited from community settings and followed until 2004	258 IDU initiating HAART between 1996 and 2002; 29% female and 95% African American	42.6% any injection drug use at HAART initiation	All individuals initiated HAART; 101 “consistent use”	Change in CD4+ cell count; change in plasma HIV RNA load
Knowlton et al., 2007 [41]	Baltimore, Maryland; Miami, Florida; New York City, New York; San Francisco, California, United States	INSPIRE	Recruited from community settings and followed from 2001 to 2005	133 IDU on HAART for at least 12 months with viral load improvements since initiation	109 (82%) any injection drug use during study period	104% adherence = 90%	Likelihood of achieving or remaining undetectable HIV RNA load
Michel et al., 2009 [48]	Paris, Nice and Marseille, France	MANIF 2000	Recruited from clinical settings between 1995 and 1997 and followed until January 2005	294 IDU on HAART with at least two study interviews	100 (34%) reported being in opioid substitution; 179 (60.9%) reported no heroin use in previous six months	All on HAART	Time to death
Baum et al., 2009 [23]	Miami, Florida, United States		Recruited from homeless shelter between 2002 and 2005	222 IDU, 77% black, 73% male	50% crack cocaine use at baseline, 6% heroin use	Approximately 65% on ART during study	Time to CD4+ cell count = 200 cells
Roux et al., 2009 [66]	Paris, Nice and Marseille, France	MANIF 2000	Recruited from clinical settings between 1995 – 1996	113 IDU, 30 (26.5%) women	30 (26.5%) heroin, 26 (23.0%) cocaine during previous six months	59 (52.2) 100% adherence to HAART by self-report	Likelihood of plasma HIV RNA load suppression
Krusi et al., 2010 [44]	Vancouver, Canada	AIDS Care Cohort to evaluate Exposure to Survival Services	Recruited from community settings and followed up from 1996 to 2007	381 participants initiating ART, 157 (41.2%) women	323 (84.8%) self-report injection drug use during previous six months at baseline	135 (39.6%) < 95% adherent to ART by pharmacy refill first six months after baseline	Likelihood of plasma HIV RNA load suppression
Omland et al., 2010 [52]	Denmark	Danish HIV Cohort Study	Recruited from specialized clinical settings and followed from January 1995 to December 2006	392 IDU with HCV co-infection, 245 (62.5%) male	Not reported	160 (40.8%) on HAART	Time to death (all-cause)