A systematic review of the impact of alcohol use disorders on HIV treatment outcomes, adherence to antiretroviral therapy and health care utilization.
A systematic review of the impact of alcohol use disorders on HIV treatment outcomes, adherence to antiretroviral therapy and health care utilization.
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DOI：
10.1016/j.drugalcdep.2010.06.014
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发表时间：
2010-12-01
影响因子：
4.2
通讯作者：
Altice, Frederick L.
中科院分区：
文献类型：
--
作者：
Azar, Marwan M.;Springer, Sandra A.;Meyer, Jaimie P.;Altice, Frederick L.
酒精使用障碍（AUDs）非常普遍，与艾滋病毒感染者不坚持抗逆转录病毒治疗、医疗保健利用率下降和艾滋病毒治疗效果差有关。系统回顾评估AUD对HIV/AIDS（PLWHA）感染者（1）药物依从性、（2）卫生保健利用和（3）生物治疗结局影响的研究。对1988年至2010年期间以英文、法文和西班牙文发表的文章，在6个电子数据库和Google Scholar中进行了查询。还检查了主要文章中的选定参考文献。选择标准包括：1）AUD和依从性（N=20）; 2）AUD和卫生服务利用（N=11）;或3）AUD与CD 4计数或HIV-1 RNA治疗结局（N=10）。排除了综述、动物研究、非同行评审文件和正在进行的未发表数据的研究。没有区分HIV阳性和HIV阴性的研究以及没有区分吸毒和酗酒的研究也被排除在外。对数据进行了提取、评价和总结。我们的研究结果一致支持AUDs与抗逆转录病毒治疗依从性下降和HIV感染者中HIV治疗结果不佳之间的关联。然而，它们对卫生保健利用的影响是可变的。
Alcohol use disorders (AUDs) are highly prevalent and associated with non-adherence to antiretroviral therapy, decreased health care utilization and poor HIV treatment outcomes among HIV-infected individuals. To systematically review studies assessing the impact of AUDs on: (1) medication adherence, (2) health care utilization and (3) biological treatment outcomes among people living with HIV/AIDS (PLWHA). Six electronic databases and Google Scholar were queried for articles published in English, French and Spanish from 1988 to 2010. Selected references from primary articles were also examined. Selection criteria included: 1) AUD and adherence (N=20); 2) AUD and health services utilization (N=11); or 3) AUD with CD4 count or HIV-1 RNA treatment outcomes (N=10). Reviews, animal studies, non-peer reviewed documents and ongoing studies with unpublished data were excluded. Studies that did not differentiate HIV+ from HIV- status and those that did not distinguish between drug and alcohol use were also excluded. Data were extracted, appraised and summarized. Our findings consistently support an association between AUDs and decreased adherence to antiretroviral therapy and poor HIV treatment outcomes among HIV-infected individuals. Their effect on health care utilization, however, was variable.
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