Chronic Venous Insufficiency in HIV-Positive Persons with and without a History of Injection Drug Use

Abstract

To examine chronic venous insufficiency in human immunodeficiency virus-positive persons with and without a history of injection drug use and to examine the extent to which neuropathy further increased the risk of chronic venous insufficiency. Cross-sectional stratified design with quota sampling. Infectious diseases clinic in a large, urban midwestern city. Human immunodeficiency virus-positive persons, 27 with no history of injection drug use and 46 with a history of injection drug use, who met the inclusion criteria, including being 30 to 65 years of age, not pregnant, and willing to respond to a questionnaire and have their lower legs examined, were enrolled until the quota for each stratum (no injection drug use and injection drug use) was filled. Chronic venous insufficiency clinical classification, injection drug use history, and presence of peripheral neuropathy. Sixty-one percent of injection drug users (28/46) presented with severe chronic venous insufficiency compared with 11% (3/27) of noninjection drug users (P< .001). The presence of lower extremity neuropathy was not significantly related to chronic venous insufficiency classification. This is the first study to report the high risk of chronic venous insufficiency in human immunodeficiency virus-infected persons who inject drugs. Chronic venous insufficiency should be assessed in human immunodeficiency virus-positive persons when there is a history of injection drug use, and measures to protect the legs should be implemented.