Marijuana use and its association with adherence to antiretroviral therapy among HIV-infected persons with moderate to severe nausea
Marijuana use and its association with adherence to antiretroviral therapy among HIV-infected persons with moderate to severe nausea
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DOI：
10.1097/00126334-200501010-00008
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发表时间：
2005-01-01
影响因子：
3.6
通讯作者：
Israelski, DM
中科院分区：
文献类型：
--
作者：
de Jong, BC;Prentiss, D;Israelski, DM
背景：坚持抗逆转录病毒治疗（ART）是成功治疗HIV感染的关键。最近的两项研究报告了大麻使用和坚持ART之间的负相关性。然而，一些患者报告说，吸食大麻可以提高ART的坚持性。因此，本研究试图确定哪些亚组的患者可能与最近的大麻使用相关，对ART有不同的坚持性。方法：在公共卫生保健系统内进行HIV/AIDS的横断面调查设计。结果：在5%的拒绝率下，252名患者完成了访谈，175名（69%）接受了ART治疗，168名（67%）提供了ART依从性数据。41名受试者（24%），主要是白人，使用大麻。在双变量分析中，未发现ART依从性与大麻使用之间存在关联（比值比[OR] = 0.92，95%CI = 0.4-1.9）。依从性与检测不到的血浆病毒呈正相关，与酒精和其他非法药物使用呈负相关。检查患者的亚组，在恶心的患者中，大麻使用者比非使用者更可能显示出与依从性的相关性（OR = 3.3），而在没有恶心的患者中，大麻使用与依从性的相关性较低（OR = 0.52，同质性P = 0.02）。这种关系在多变量分析控制恶心和大麻使用之间的相互作用，其中其他非法药物的使用仍然是一个因素相关的nonadherence.Discussion：这些数据表明，药用大麻可能会促进，而不是阻碍，抗逆转录病毒治疗依从性恶心的患者，在对比使用其他非法物质，这与较低的抗逆转录病毒治疗依从率。为了证明大麻和坚持之间的因果关系，需要进行纵向或对照研究。
Background: Adherence to antiretroviral therapy (ART) is essential to successful treatment of HIV infection. Two recent studies reported a negative correlation between marijuana use and adherence to ART. Some patients, however, report that smoking marijuana improves adherence to ART. This study therefore sought to identify which subgroups of patients may have differential adherence to ART in association with recent marijuana use.Methods: Cross-sectional survey design within a public health care system for HIV/AIDS.Results: With a 5% refusal rate, 252 patients completed the interview, 175 (69%) were on ART, and 168 (67%) provided ART adherence data. Forty-one subjects (24%), predominantly whites, used marijuana. In bivariate analysis, no association between ART adherence and marijuana use was found (odds ratio [OR] = 0.92, 95% CI = 0.4-1.9). Adherence was positively associated with undetectable plasma virus and negatively associated with alcohol and other illicit drug use. Examining subgroups of patients, among those with nausea, marijuana users were more likely to show an association with adherence than nonusers (OR = 3.3), while among those without nausea, marijuana use was lower associated with adherence (OR = 0.52, P for homogeneity 0.02). This relationship was confirmed in multivariate analyses controlling for the interactions between nausea and marijuana use, in which other illicit drug use remained a factor related to nonadherence.Discussion: These data suggest that medicinal use of marijuana may facilitate, rather than impede, ART adherence for patients with nausea, in contrast to the use of other illicit substances, which were associated with lower rates of ART adherence. To demonstrate any causal relationship between marijuana and adherence would require a longitudinal or controlled study.