Methadone maintenance therapy and viral suppression among HIV-infected opioid users: The impacts of crack and injection cocaine use
Methadone maintenance therapy and viral suppression among HIV-infected opioid users: The impacts of crack and injection cocaine use
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DOI：
10.1016/j.drugalcdep.2016.09.013
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发表时间：
2016-11-01
影响因子：
4.2
通讯作者：
Milloy, M-J
中科院分区：
文献类型：
--
作者：
Socias, M. Eugenia;Wood, Evan;Milloy, M-J
背景：美沙酮维持治疗（MMT）可改善吸毒者（PWUD）的HIV治疗结果。在持续使用可卡因的情况下，这些益处在多大程度上是持续的尚不清楚。我们评估了与可卡因使用的离散模式相关的MMT对HIV病毒载量（VL）抑制的不同影响。方法：数据来自ACCESS，这是加拿大温哥华hiv阳性PWUD的前瞻性队列。使用广义线性混合效应来模拟MMT对可卡因注射频率和快克吸烟频率（>= daily vs = 1）在2005年至2014年之间的VL抑制的独立影响。基线时，304人（77%）报告参与MMT， 37人(9%)>=每日注射可卡因，158人(40%)>=每日吸食快克。在调整后的分析中，MMT仍然与两层快克吸烟者VL抑制的几率增加独立相关（AOR= 3.11, 95%CI: 1.86-5.21， AOR= 1.48, 95%CI: 1.04-2.09）
Background: Methadone maintenance therapy (MMT) is associated with improved HIV treatment outcomes among people who use drugs (PWUD). The extent to which these benefits are sustained in the context of ongoing cocaine use is unclear. We assessed differential impacts of MMT on HIV viral load (VL) suppression in relation to discrete patterns of cocaine use.Methods: Data was drawn from ACCESS, a prospective cohort of HIV-positive PWUD in Vancouver, Canada. Generalized linear mixed-effects were used to model the independent effect of MMT on VL suppression across strata of frequency of cocaine injection and crack smoking (>= daily versus = 1 study interview between 2005 and 2014. At baseline, 304 (77%) reported participation in MMT, 37 (9%) >= daily cocaine injection, and 158 (40%) >= daily crack smoking. In adjusted analyses, MMT remained independently associated with increased odds of VL suppression in both strata of crack smokers (AOR= 3.11, 95% CI: 1.86-5.21 and AOR= 1.48, 95%CI: 1.04-2.09, for >= daily and