Opioid Use Disorders in People Living with HIV/AIDS: A Review of Implications for Patient Outcomes, Drug Interactions, and Neurocognitive Disorders.
Opioid Use Disorders in People Living with HIV/AIDS: A Review of Implications for Patient Outcomes, Drug Interactions, and Neurocognitive Disorders.
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DOI：
10.3390/pharmacy8030168
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发表时间：
2020-09-11
期刊：
影响因子：
--
通讯作者：
Kumar S
中科院分区：
文献类型：
--
作者：
Cernasev A;Veve MP;Cory TJ;Summers NA;Miller M;Kodidela S;Kumar S
阿片类药物流行病在美国产生了重大的负面影响，艾滋病毒/艾滋病感染者（PLWHA）是一个脆弱的亚群，长期使用阿片类药物或阿片类药物使用障碍（OUD）有可能产生负面后遗症。众所周知，艾滋病毒感染者和艾滋病患者会遭受与艾滋病毒有关的疼痛，通常用阿片类药物治疗，导致随后的成瘾性疾病。艾滋病毒感染者和吸毒者在艾滋病毒护理连续体中流失的风险增加，包括不理想的艾滋病毒实验室检测，延迟进入艾滋病毒护理，以及开始或坚持抗逆转录病毒治疗。对于患有OUD的艾滋病毒/艾滋病感染者，特别是生活在农村地区的艾滋病毒/艾滋病感染者来说，OUD治疗的障碍，如药物辅助治疗也很明显。此外，PLWHA和OUD通过抗逆转录病毒-阿片代谢途径相关抑制/诱导或通过人类ether-a-go-go相关基因钾离子通道途径发生严重药物相互作用的风险很高。艾滋病毒相关的神经认知障碍也可以通过阿片类药物使用的脱靶炎症作用而增强。PLWHA和OUD可能需要更密集，个性化的方案来维持对潜在阿片类药物成瘾的治疗，并提供积极的社会支持，以帮助改善患者的预后。需要在对PLWHA和OUD的理解和管理方面取得进展，以改善患者护理。本文综述了处方和非处方阿片类药物在PLWHA中的作用。
The opioid epidemic has had a significant, negative impact in the United States, and people living with HIV/AIDS (PLWHA) represent a vulnerable sub-population that is at risk for negative sequela from prolonged opioid use or opioid use disorder (OUD). PLWHA are known to suffer from HIV-related pain and are commonly treated with opioids, leading to subsequent addictive disorders. PLWHA and OUD are at an increased risk for attrition in the HIV care continuum, including suboptimal HIV laboratory testing, delayed entry into HIV care, and initiation or adherence to antiretroviral therapy. Barriers to OUD treatment, such as medication-assisted therapy, are also apparent for PLWHA with OUD, particularly those living in rural areas. Additionally, PLWHA and OUD are at a high risk for serious drug–drug interactions through antiretroviral-opioid metabolic pathway-related inhibition/induction, or via the human ether-a-go-go-related gene potassium ion channel pathways. HIV-associated neurocognitive disorders can also be potentiated by the off-target inflammatory effects of opioid use. PLWHA and OUD might require more intensive, individualized protocols to sustain treatment for the underlying opioid addiction, as well as to provide proactive social support to aid in improving patient outcomes. Advancements in the understanding and management of PLWHA and OUD are needed to improve patient care. This review describes the effects of prescription and non-prescription opioid use in PLWHA.
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影响因子：
1.3
作者：
Acevedo A;Garnick DW;Lee MT;Horgan CM;Ritter G;Panas L;Davis S;Leeper T;Moore R;Reynolds M
通讯作者：
Reynolds M
影响因子：
9.7
作者：
Clark, Robin E.;Samnaliev, Mihail;Leung, Gary Y.
通讯作者：
Leung, Gary Y.
DOI：
10.1016/j.japh.2016.11.003
发表时间：
2017-03-01
影响因子：
2.1
作者：
Bounthavong, Mark;Harvey, Michael A.;Christopher, Melissa L. D.
通讯作者：
Christopher, Melissa L. D.
影响因子：
3.7
作者：
Brooks, Audrey J.;Lokhnygina, Yuliya;Greenfield, Shelly F.
通讯作者：
Greenfield, Shelly F.
影响因子：
5.8
作者：
Drewe, J;Gutmann, H;Huwyler, J
通讯作者：
Huwyler, J