Detrimental effects of continued illicit drug use on the treatment of HIV-1 infection
Detrimental effects of continued illicit drug use on the treatment of HIV-1 infection
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DOI：
10.1097/00126334-200107010-00006
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发表时间：
2001-07-01
期刊：
影响因子：
--
通讯作者：
Moore, RD
中科院分区：
文献类型：
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作者：
Lucas, GM;Cheever, LW;Moore, RD
目的：确定物质滥用状态（活跃）的影响。设计：对764名HIV-1感染患者进行前瞻性队列研究，这些患者参加了一个城市HIV诊所并参加了一个标准化的访谈。主要结果测量：既往使用HAART、自我报告的抗逆转录病毒治疗依从性、HIV-1 RNA水平和CD 4（+）淋巴细胞计数相对于之前峰值和最低值的变化。44%的活跃吸毒者未能利用高效抗逆转录病毒疗法，而22%的前吸毒者和18%的非吸毒者则未能利用高效抗逆转录病毒疗法（两项比较的p <0.001）。与会者：接受抗逆转录病毒治疗的患者中，活跃的药物使用者更有可能报告药物不依从性（34% vs. 24%的非使用者和17%的前使用者），HIV-I RNA较基线降低的中位数较小。（0.8 log（10）拷贝/ml，非使用者为1.7，前使用者为1.6），CD 4（+）淋巴细胞计数较基线的中位增幅较小（65个细胞/mm（3）vs.非使用者为116个，前使用者为122个）（对于与活跃用户的所有比较，p <0.05）。积极药物使用与HAART利用不足、不依从和对治疗的不良病毒学和免疫学应答密切相关，而前吸毒者和非吸毒者在所有结果上都是相似的。Lire需要将HIV-1和药物滥用治疗相结合的有效策略。
Objective: To identify the effects of substance abuse status (active. former, and never) on utilization of highly active antiretroviral therapy (HAART), medication adherence, and virologic and immunologic responses to therapy.Design: Prospective cohort study of 764 HIV-1-infected patients who attended an urban HIV clinic and participated in a standardized interview.Main Outcome Measures: Past utilization of HAART, self-reported nonadherence with antiretroviral therapy, and changes in HIV-1 RNA level and CD4(+) lymphocyte count relative to prior peak and nadir, respectively.Results: Forty-four percent of active drug users failed to utilize HAART compared with 22% of former drug users and 18% of non-drug users (p < .001 for both comparisons). Among participants: who were taking antiretroviral therapy when interviewed, active drug users were more likely to report medication nonadherence (34% vs. 24% of nonusers and 17% of former users), had a smaller median reduction in HIV-I RNA from baseline (0.8 log(10) copies/ml vs. 1.7 in nonusers and 1.6 in former users), and had smaller median increases in CD4(+) lymphocyte count from baseline (65 cells/mm(3) vs. 116 in nonusers and 122 in former users) (p < .05 for all comparisons with active users).Conclusions: Active drug use was strongly associated with underutilization of HAART, nonadherence, and inferior virologic and immunologic responses to therapy, whereas former drug users and non-drug users were similar in all outcomes. Effective strategies Lire needed that integrate HIV-I and substance abuse treatments.