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Opioids and HIV

Michelle M Van Handel, Charles E Rose, Elaine J Hallisey, Jessica L Kolling, Jon E Zibbell, Brian Lewis, Michele K Bohm, Christopher M Jones, Barry E Flanagan, Azfar-E-Alam Siddiqi, Kashif Iqbal, Andrew L Dent, Jonathan H Mermin, Eugene McCray, John W Ward, John T Brooks
OBJECTIVE: A recent HIV outbreak in a rural network of persons who inject drugs (PWID) underscored the intersection of the expanding epidemics of opioid abuse, unsterile injection drug use (IDU), and associated increases in hepatitis C virus (HCV) infections. We sought to identify US communities potentially vulnerable to rapid spread of HIV, if introduced, and new or continuing high rates of HCV infections among PWID. DESIGN: We conducted a multistep analysis to identify indicator variables highly associated with IDU...
November 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Lu Cao, Mingui Fu, Santosh Kumar, Anil Kumar
Methamphetamine (METH), a commonly used controlled substance, is known to exacerbate neuropathological dysfunction in HIV-infected individuals. The neuropathological manifestation results from cell death or dysfunction in the central nervous system (CNS) wherein autophagy is expected to have an important role. Autophagy is generally considered protective during deprivation/stress. However, excessive autophagy can be destructive, leading to autophagic cell death. This study was designed to investigate if METH and HIV-1 gp120 interact to induce autophagy in SVGA astrocytes, and whether autophagy is epiphenomenal or it has a role in METH- and gp120-induced cytotoxicity...
October 20, 2016: Cell Death & Disease
Rosalind L Coleman, Susie McLean
INTRODUCTION: The offer of pre-exposure prophylaxis (PrEP) is recommended as an additional option for HIV prevention for people at substantial risk of HIV infection as part of combination HIV prevention approaches. Implementing this depends on integrating PrEP in public health programmes that address risky practices with evidence-based interventions, and that operate in an enabling legal and policy environment for the delivery of health services to those at higher risk of HIV infection...
2016: Journal of the International AIDS Society
Pranjali Dalvi, Himanshu Sharma, Mahendran Chinnappan, Miles Sanderson, Julie Allen, Ruoxi Zeng, Augustine Choi, Amy O'Brien-Ladner, Navneet K Dhillon
Intravenous drug use is one of the major risk factors for HIV-infection in HIV-related pulmonary arterial hypertension patients. We previously demonstrated exaggerated pulmonary vascular remodeling with enhanced apoptosis followed by increased proliferation of pulmonary endothelial cells on simultaneous exposure to both opioids and HIV protein(s). Here we hypothesize that the exacerbation of autophagy may be involved in the switching of endothelial cells from an early apoptotic state to later hyper-proliferative state...
October 10, 2016: Autophagy
Christopher K Arnatt, Bethany A Falls, Yunyun Yuan, Thomas J Raborg, Ruturaj R Masvekar, Nazira El-Hage, Dana E Selley, Anthony V Nicola, Pamela E Knapp, Kurt F Hauser, Yan Zhang
Modern antiretroviral therapies have provided HIV-1 infected patients longer lifespans and better quality of life. However, several neurological complications are now being seen in these patients due to HIV-1 associated injury of neurons by infected microglia and astrocytes. In addition, these effects can be further exacerbated with opiate use and abuse. One possible mechanism for such potentiation effects of opiates is the interaction of the mu opioid receptor (MOR) with the chemokine receptor CCR5 (CCR5), a known HIV-1 co-receptor, to form MOR-CCR5 heterodimer...
September 26, 2016: Bioorganic & Medicinal Chemistry
Daniel P Riggins, Chinazo O Cunningham, Yuming Ning, Aaron D Fox
BACKGROUND: Opioid use disorder is a common cause of morbidity and mortality among people living with HIV/AIDS. Buprenorphine maintenance treatment (BMT) is an effective means of therapy, but patients with recent criminal justice involvement may need more support during BMT than other patients. We hypothesized that recently incarcerated BMT patients who initiated treatment in primary care would have poorer treatment outcomes than those who were not recently incarcerated. METHODS: We analyzed data from a multi-site cohort study of BMT integrated into HIV care...
August 11, 2016: Substance Abuse
M Eugenia Socías, Evan Wood, Will Small, Huiru Dong, Jean Shoveller, Thomas Kerr, Julio Montaner, M-J Milloy
BACKGROUND: Methadone maintenance therapy (MMT) is associated with improved HIV treatment outcomes among people who use drugs (PWUD). The extent to which these benefits are sustained in the context of ongoing cocaine use is unclear. We assessed differential impacts of MMT on HIV viral load (VL) suppression in relation to discrete patterns of cocaine use. METHODS: Data was drawn from ACCESS, a prospective cohort of HIV-positive PWUD in Vancouver, Canada. Generalized linear mixed-effects were used to model the independent effect of MMT on VL suppression across strata of frequency of cocaine injection and crack smoking (≥daily versus <daily), after adjustment for confounders...
September 20, 2016: Drug and Alcohol Dependence
Stéphane Mouly, Célia Lloret-Linares, Pierre-Olivier Sellier, Damien Sene, J-F Bergmann
An interaction of drug with food, herbs, and dietary supplements is usually the consequence of a physical, chemical or physiologic relationship between a drug and a product consumed as food, nutritional supplement or over-the-counter medicinal plant. The current educational review aims at reminding to the prescribing physicians that the most clinically relevant drug-food interactions may not be strictly limited to those with grapefruit juice and with the Saint John's Wort herbal extract and may be responsible for changes in drug plasma concentrations, which in turn decrease efficacy or led to sometimes life-threatening toxicity...
September 28, 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Robert P Schwartz, Sharon M Kelly, Shannon Gwin Mitchell, Jan Gryczynski, Kevin E O'Grady, Devang Gandhi, Yngvild Olsen, Jerome H Jaffe
BACKGROUND AND AIMS: Methadone patients who discontinue treatment are at high risk of relapse, yet a substantial proportion discontinue treatment within the first year. We investigated whether a patient-centered approach to methadone treatment improved participant outcomes at 12-months following admission, compared with methadone treatment-as-usual. DESIGN: Two-arm open-label randomized trial. SETTING: Two methadone treatment programs (MTPs) in Baltimore, Maryland, USA...
September 23, 2016: Addiction
Daniel Werb, Richard Garfein, Thomas Kerr, Peter Davidson, Perrine Roux, Marie Jauffret-Roustide, Marc Auriacombe, Will Small, Steffanie A Strathdee
BACKGROUND: Injection drug use remains a primary driver of HIV and HCV-related harms globally. However, there is a gap in efforts to prevent individuals from transitioning into injecting. People who inject drugs (PWID) play a key role in the transition of others into injecting, and while behavioral interventions have been developed to address this phenomenon, socio-structural approaches remain unexplored. To that end, we hypothesize that certain interventions designed to reduce injecting-related risk behaviors may also reduce the risk that PWID expose and introduce others into injecting...
2016: Harm Reduction Journal
Julie R Gaither, Joseph L Goulet, William C Becker, Stephen Crystal, E Jennifer Edelman, Kirsha Gordon, Robert D Kerns, David Rimland, Melissa Skanderson, Amy C Justice, David A Fiellin
OBJECTIVE: Patients with substance use disorders (SUDs) prescribed long-term opioid therapy (LtOT) are at risk for overdose and mortality. Prior research has shown that receipt of LtOT in accordance with clinical practice guidelines has the potential to mitigate these outcomes. Our objective was to determine whether the presence of a SUD modifies the association between guideline-concordant care and 1-year all-cause mortality among patients receiving LtOT for pain. METHODS: Among HIV+ and HIV- patients initiating LtOT (≥90 days opioids) between 2000 and 2010 as part of the Veterans Aging Cohort Study, we used time-updated Cox regression and propensity-score matching to examine-stratified by SUD status-the association between 1-year all-cause mortality and 3 quality indicators derived from national opioid-prescribing guidelines...
September 8, 2016: Journal of Addiction Medicine
Benjamin Wenz, Stine Nielsen, Martyna Gassowski, Claudia Santos-Hövener, Wei Cai, R Stefan Ross, Claus-Thomas Bock, Boris-Alexander Ratsch, Claudia Kücherer, Norbert Bannert, Viviane Bremer, Osamah Hamouda, Ulrich Marcus, Ruth Zimmermann
BACKGROUND: People who inject drugs (PWID) are at increased risk of acquiring and transmitting HIV and Hepatitis C (HCV) due to sharing injection paraphernalia and unprotected sex. To generate seroprevalence data on HIV and HCV among PWID and related data on risk behaviour, a multicentre sero- and behavioural survey using respondent driven sampling (RDS) was conducted in eight German cities between 2011 and 2014. We also evaluated the feasibility and effectiveness of RDS for recruiting PWID in the study cities...
2016: BMC Public Health
Dexter R Voisin, Anna L Hotton, John A Schneider
Younger Black men who have sex with men (YBMSM) have the highest rates of HIV incidence in the U.S. and are also exposed to high life stressors (e.g., unemployment, incarceration, and exposure to communality). This study assessed whether life stressors were related to drug use and sexual risk behaviors among a representative sample of YBMSM. The South Side of Chicago and selected adjacent suburbs represents the most populous contiguous Black community in the U.S. Over 10% of the estimated YBMSM population in this geographic region were sampled...
September 2, 2016: AIDS Care
Alia A Al-Tayyib, Stephen Koester, Paula Riggs
BACKGROUND: The intertwining prescription opioid and heroin epidemic is a major public health problem in the United States, with increasing morbidity and mortality among persons who use these substances. We examined differences between persons who reported being hooked on prescription opioids prior to injecting for the first time and those who did not by demographics, injection and non-injection characteristics, and overdose. METHODS: Between June and December 2015, persons who inject drugs were recruited using respondent-driven sampling as part of the National HIV Behavioral Surveillance system in Denver, Colorado...
August 19, 2016: Addictive Behaviors
Diep Nguyen Bich, P Todd Korthuis, Trang Nguyen Thu, Hoa Van Dinh, Giang Le Minh
BACKGROUND: Integrated care models for HIV and substance use disorder (SUD) care are proposed as a strategy for closing gaps in the HIV care continuum and decreasing HIV transmission. We examined attitudes regarding integration of HIV and SUD treatment among HIV-infected patients with illicit drug and unhealthy alcohol use. METHOD: We conducted a cross-sectional survey of HIV-infected patients receiving care at 5 HIV clinics in Hanoi, Vietnam, regarding substance use and attitudes toward HIV and SUD treatment integration...
October 2016: Journal of Substance Abuse Treatment
Joni Teoh Bing Fei, Anne Yee, Mohamad Hussain Bin Habil, Mahmoud Danaee
Methadone maintenance therapy has been found to be an effective harm reduction treatment for opioid use disorder. However evidence of its benefits over a longer duration of treatment is limited as most studies focus on its short term benefits. As methadone maintenance therapy reaches a decade since its implementation in Malaysia, this study sought to examine the effectiveness of methadone treatment, change in quality of life among patients since entry to methadone treatment, as well as factors predicting the magnitude of change in quality of life...
October 2016: Journal of Substance Abuse Treatment
Kanna Hayashi, Evan Wood, Thomas Kerr, Huiru Dong, Paul Nguyen, Cathy M Puskas, Silvia Guillemi, Julio S G Montaner, Michael-John Milloy
BACKGROUND: Crack cocaine use is known to contribute to poor adherence to antiretroviral medications; however, little is known about facilitators of or barriers to effective HIV treatment use among HIV-infected crack cocaine users. We sought to identify correlates of optimal pharmacy refill adherence for antiretroviral medications and plasma HIV RNA viral load (pVL) suppression among this population. METHODS: Data from a prospective cohort of HIV-positive people who use illicit drugs in Vancouver, Canada, were linked to comprehensive HIV clinical monitoring and pharmacy dispensation records...
2016: BMC Infectious Diseases
Geetanjoli Banerjee, E Jennifer Edelman, Declan T Barry, William C Becker, Magdalena Cerdá, Stephen Crystal, Julie R Gaither, Adam J Gordon, Kirsha S Gordon, Robert D Kerns, Silvia S Martins, David A Fiellin, Brandon D L Marshall
AIMS: To estimate the influence of non-medical use of prescription opioids (NMUPO) on heroin initiation among US veterans receiving medical care. DESIGN: Using a multivariable Cox regression model, we analyzed data from a prospective, multi-site, observational study of HIV-infected and an age/race/site-matched control group of HIV-uninfected veterans in care in the United States. Approximately annual behavioral assessments were conducted and contained self-reported measures of NMUPO and heroin use...
November 2016: Addiction
Roman Shrestha, Damian Weikum, Michael Copenhaver, Frederick L Altice
Prior research has widely recognized neurocognitive impairment (NCI), depression, and alcohol use disorders (AUDs) as important negative predictors of health-related quality of life (HRQoL) among people living with HIV (PLWH). No studies to date, however, have explored how these neuropsychological factors operate together and affect HRQoL. Incarcerated male PLWH (N = 301) meeting criteria for opioid dependence were recruited from Malaysia's largest prison. Standardized scales for NCI, depression, alcohol use disorders (AUDs) and HRQoL were used to conduct a moderated mediation model to explore the extent to which depression mediated the relationship between NCI, HRQoL, and AUDs using an ordinary least squares regression-based path analytic framework...
August 20, 2016: AIDS and Behavior
Joshua D Lee, Edward V Nunes, Patricia Novo Mpa, Genie L Bailey, Gregory S Brigham, Allan J Cohen, Marc Fishman, Walter Ling, Robert Lindblad, Dikla Shmueli-Blumberg, Don Stablein, Jeanine May, Dagmar Salazar, David Liu, John Rotrosen
INTRODUCTION: For opioid-dependent patients in the US and elsewhere, detoxification and counseling-only aftercare are treatment mainstays. Long-term abstinence is rarely achieved; many patients relapse and overdose after detoxification. Methadone, buprenorphine-naloxone (BUP-NX) and extended-release naltrexone (XR-NTX) can prevent opioid relapse but are underutilized. This study is intended to develop an evidence-base to help patients and providers make informed choices and to foster wider adoption of relapse-prevention pharmacotherapies...
September 2016: Contemporary Clinical Trials
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