Journal Article

Optimizing Treatment Outcomes in HIV-Infected Patients with Substance Abuse Issues

David D. Celentano and Greg Lucas

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 45, issue Supplement_4, pages S318-S323
Published in print December 2007 | ISSN: 1058-4838
Published online December 2007 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/522557
Optimizing Treatment Outcomes in HIV-Infected Patients with Substance Abuse Issues

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Drug abuse is associated with poorer virologic and clinical outcomes for patients with human immunodeficiency virus (HIV) infection. Limited evidence, primarily from in vitro and animal studies, shows that some abused drugs (e.g., opioids) may have direct effects on HIV pathology and the immune response to infection, but the clinical effects are not known. Clinical data indicate that the primary effect of drug abuse on HIV disease progression is mediated via factors that may limit access and/or adherence to highly active antiretroviral therapy (HAART). Drug abuse is associated with reduced adherence to HAART, which is strongly correlated with poorer virologic and clinical outcomes. However, the virologic and clinical effects of HAART are generally equivalent among drug abusers and non–drug abusers who adhere to therapy. These results underscore the importance of integrating medical and substance abuse interventions for HIV-positive drug abusers, to improve adherence to HAART and optimize outcomes of treatment for HIV infection.

Journal Article.  4402 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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