Methadone maintenance therapy promotes initiation of antiretroviral therapy among injection drug users.
Methadone maintenance therapy promotes initiation of antiretroviral therapy among injection drug users.
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DOI：
10.1111/j.1360-0443.2010.02905.x
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发表时间：
2010-05
期刊：
影响因子：
--
通讯作者：
Wood E
中科院分区：
文献类型：
--
作者：
Uhlmann S;Milloy MJ;Kerr T;Zhang R;Guillemi S;Marsh D;Hogg RS;Montaner JS;Wood E
尽管抗逆转录病毒疗法（ART）已被证明具有益处，但许多感染艾滋病毒的注射吸毒者（IDU）即使在免费医疗保健的环境中也无法获得治疗。我们研究了美沙酮维持治疗（MMT）是否增加了免费医疗的IDU人群中ART的启动和依从性。我们前瞻性地研究了一组使用阿片类药物的抗逆转录病毒初治HIV感染的IDU，并研究了与开始抗逆转录病毒治疗以及随后的依从性相关的因素。采用考克斯比例风险回归分析与首次开始抗逆转录病毒治疗时间独立相关的因素。在1996年5月至2008年4月期间，招募了231例使用IDU的抗逆转录病毒初治HIV感染阿片类药物，其中152例（65.8%）开始ART，发病密度为30.5（95%置信区间[CI]：25.9-35.6）/100人-年。在调整了时间更新的临床特征和其他潜在混杂因素后，MMT的使用与抗逆转录病毒治疗的更快吸收独立相关（相对风险= 1.62 [95%CI：1.15-2.28]; p = 0.006）。在首次开始抗逆转录病毒治疗后，处方美沙酮的患者也有更高的ART依从率（比值比= 1.49 [95%CI：1.07-2.08]; p = 0.019）。这些结果表明，MMT有助于更快地启动和随后坚持使用阿片类药物的HIV感染的IDU之间的ART。消除美沙酮使用和供应方面的国际障碍可能会大大增加这一人群接受艾滋病毒治疗的人数。
Despite proven benefits of antiretroviral therapy (ART), many HIV-infected injection drug users (IDU) do not access treatment even in settings with free health care. We examined whether methadone maintenance therapy (MMT) increased initiation and adherence to ART among an IDU population with free health care. We prospectively examined a cohort of opioid-using antiretroviral-naïve HIV-infected IDU and investigated factors associated with initiation of antiretroviral therapy as well as subsequent adherence. Factors independently associated with time to first initiation of antiretroviral therapy were modelled using Cox proportional hazards regression. Between May 1996 and April 2008, 231 antiretroviral-naïve HIV-infected opioid using IDU were enrolled, among whom 152 (65.8%) initiated ART, for an incidence density of 30.5 (95% confidence interval [CI]: 25.9–35.6) per 100 person-years. After adjustment for time-updated clinical characteristics and other potential confounders, use of MMT was independently associated with more rapid uptake of antiretroviral therapy (relative hazard = 1.62 [95% CI: 1.15–2.28]; p = 0.006). Those prescribed methadone also had higher rates of ART adherence after first antiretroviral initiation (odds ratio = 1.49 [95% CI: 1.07–2.08]; p = 0.019). These results demonstrate that MMT contributes to more rapid initiation and subsequent adherence to ART among opioid-using HIV-infected IDU. Addressing international barriers to the use and availability of methadone may dramatically increase uptake of HIV treatment among this population.
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DOI：
10.1097/00126334-200010010-00005
发表时间：
2000-10-01
期刊：
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
影响因子：
--
作者：
Cunningham, WE;Markson, LE;Wenger, NS
通讯作者：
Wenger, NS
DOI：
10.1097/00126334-200107010-00006
发表时间：
2001-07-01
期刊：
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
影响因子：
--
作者：
Lucas, GM;Cheever, LW;Moore, RD
通讯作者：
Moore, RD
影响因子：
6.4
作者：
Lundgren, Jens D.;Babiker, Abdel;Phillips, Andrew N.
通讯作者：
Phillips, Andrew N.
影响因子：
4.4
作者：
Grabowski, J;Shearer, J;Negus, SS
通讯作者：
Negus, SS
影响因子：
4.4
作者：
Friedman, Samuel R.;Tempalski, Barbara;Jarlais, Don C. Des
通讯作者：
Jarlais, Don C. Des