Low Non-structured Antiretroviral Therapy Interruptions in HIV-Infected Persons Who Inject Drugs Receiving Multidisciplinary Comprehensive HIV Care at an Outpatient Drug Abuse Treatment Center

AIDS Behav. 2016 May;20(5):1068-75. doi: 10.1007/s10461-015-1211-y.

Abstract

Continuous HIV treatment is necessary to ensure successful combined antiretroviral therapy (cART). The aim of this study was to evaluate the incidence of patient-initiated non-structured treatment interruptions in HIV-infected persons who inject drugs and who received a multidisciplinary comprehensive program, including medical HIV care, drug-dependence treatment and psychosocial support, at a drug outpatient addiction center. Non-structured treatment interruptions were defined as ≥30 consecutive days off cART without medical indication. During a median follow-up of 53.8 months, 37/132 (28 %) patients experienced the first non-structured treatment interruptions. The cumulative probability of cART interruption at 5 years was 31.2 % (95 % CI 22.4-40.0). Current drug use injection ≥1/day (HR 14.77; 95 % CI 5.90-36.96) and cART naive patients (HR 0.35, 95 % CI 0.14-0.93) were predictive factors for non-structured treatment interruptions. HIV care provided at a drug addiction center is a useful strategy to sustain continuous cART, however, drug abstinence is essential for the long-term maintenance of cART.

Keywords: Antiretroviral; Drugs; HIV; Interruptions; Therapy.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Antiretroviral Therapy, Highly Active*
  • Comorbidity
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • HIV Infections / psychology
  • HIV Infections / virology
  • Humans
  • Longitudinal Studies
  • Male
  • Methadone / administration & dosage*
  • Middle Aged
  • Opiate Substitution Treatment / statistics & numerical data*
  • Outpatients
  • Spain / epidemiology
  • Substance Abuse Treatment Centers
  • Substance Abuse, Intravenous / complications*
  • Substance Abuse, Intravenous / drug therapy
  • Substance Abuse, Intravenous / epidemiology
  • Treatment Outcome

Substances

  • Methadone