Improved HIV and substance abuse treatment outcomes for released HIV-infected prisoners: the impact of buprenorphine treatment.
Improved HIV and substance abuse treatment outcomes for released HIV-infected prisoners: the impact of buprenorphine treatment.
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DOI：
10.1007/s11524-010-9438-4
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发表时间：
2010-07
影响因子：
6.6
通讯作者：
Altice, Frederick L.
中科院分区：
文献类型：
--
作者：
Springer, Sandra Ann;Chen, Shu;Altice, Frederick L.
感染艾滋病毒的囚犯在获释后情况很差。虽然很少可用，但阿片类激动剂治疗（OAT）可能是改善释放后艾滋病毒和药物滥用治疗结果的一种方法。在一项直接给予抗逆转录病毒治疗的随机对照试验中，69名感染艾滋病毒的囚犯中，48名（70%）符合DSM-IV阿片类药物依赖标准。其中，30例（62.5%）选择OAT，作为美沙酮（N = 7，14.5%）或丁丙诺啡/纳洛酮（BPN/NLX; N = 23，48.0%）。对于选择BPN/NLX的患者，报告了为期12周的HIV和药物滥用治疗结局作为子研究。保留率高：21例（91%）完成BPN/NLX诱导，12周后17例（74%）仍接受BPN/NLX。与基线相比，第12周时病毒载量（61% vs 63% log 10拷贝/mL）和平均CD 4计数（367 vs 344个细胞/mL）未检出的比例保持不变。在完成诱导的21人中，阿片类药物阴性尿液检测仍为83%。使用10分Likert量表的平均值，阿片类药物渴求在BPN/NLX诱导后3天内从6.0降至1.8，在整个12周内满意度保持在9.5。不良事件较少且轻微。BPN/NLX治疗对已释放的HIV感染囚犯的HIV和阿片类药物治疗结果是可接受的、安全有效的。需要进一步的随机对照试验来证实它在这一高度脆弱人群中的益处。
HIV-infected prisoners fare poorly after release. Though rarely available, opioid agonist therapy (OAT) may be one way to improve HIV and substance abuse treatment outcomes after release. Of the 69 HIV-infected prisoners enrolled in a randomized controlled trial of directly administered antiretroviral therapy, 48 (70%) met DSM-IV criteria for opioid dependence. Of these, 30 (62.5%) selected OAT, either as methadone (N = 7, 14.5%) or buprenorphine/naloxone (BPN/NLX; N = 23, 48.0%). Twelve-week HIV and substance abuse treatment outcomes are reported as a sub-study for those selecting BPN/NLX. Retention was high: 21 (91%) completed BPN/NLX induction and 17 (74%) remained on BPN/NLX after 12 weeks. Compared with baseline, the proportion with a non-detectable viral load (61% vs 63% log10 copies/mL) and mean CD4 count (367 vs 344 cells/mL) was unchanged at 12 weeks. Opiate-negative urine testing remained 83% for the 21 who completed induction. Using means from 10-point Likert scales, opioid craving was reduced from 6.0 to 1.8 within 3 days of BPN/NLX induction and satisfaction remained high at 9.5 throughout the 12 weeks. Adverse events were few and mild. BPN/NLX therapy was acceptable, safe and effective for both HIV and opioid treatment outcomes among released HIV-infected prisoners. Future randomized controlled trials are needed to affirm its benefit in this highly vulnerable population.
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影响因子：
120.7
作者：
Chandler, Redonna K.;Fletcher, Bennett W.;Volkow, Nora D.
通讯作者：
Volkow, Nora D.
影响因子：
1.9
作者：
NURCO, DN;HANLON, TE;STEPHENSON, P
通讯作者：
STEPHENSON, P
DOI：
10.1097/01.qai.0000219769.89679.ec
发表时间：
2006-04-15
影响因子：
3.6
作者：
Bruce, RD;Altice, FL;Friedland, GH
通讯作者：
Friedland, GH
影响因子：
3.8
作者：
Moatti, JP;Carrieri, MP;Moreau, J
通讯作者：
Moreau, J
影响因子：
120.7
作者：
Baillargeon, Jacques;Giordano, Thomas P.;Paar, David P.
通讯作者：
Paar, David P.