Nonstructured Treatment Interruptions Among Injection Drug Users in Baltimore, MD
JAIDS Journal of Acquired Immune Deficiency SyndromesPublished 1 April 2009Open access
Ravi Kavasery, Noya Galai, Jacquie Astemborski, Gregory M. Lucas, David D. Celentano, Gregory D. Kirk
Citations48
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
NTIs were common in this population and occurred most frequently in the setting of active drug use and disruption of health care, and effective linkages between primary care for HIV and substance abuse treatment may improve HAART outcomes.
Abstract
NTIs were common in this population and occurred most frequently in the setting of active drug use and disruption of health care. Effective linkages between primary care for HIV and substance abuse treatment may improve HAART outcomes in this population.
Keywords
Medicine
New England Journal of MedicineDeclining Morbidity and Mortality among Patients with Advanced Human Immunodeficiency Virus Infection
9,465 Citations1998Frank J. Palella, Kathleen M. Delaney +6 more
The recent declines in morbidity and mortality due to AIDS are attributable to the use of more intensive antiretroviral therapies.
New England Journal of MedicineCD4+ Count–Guided Interruption of Antiretroviral Treatment
2,203 Citations2006Wafaa El‐Sadr
Episodic antiretroviral therapy guided by the CD4+ count significantly increased the risk of opportunistic disease or death from any cause, as compared with continuous antireteviral therapy, largely as a consequence of lowering theCD4+ cell count and increasing the viral load.
The LancetChanging patterns of mortality across Europe in patients infected with HIV-1
1,284 Citations1998Amanda Mocroft, Stefano Vella +9 more
Death rates across Europe among patients infected with HIV-1 have been falling since September, 1995, and at the beginning of 1998 were less than a fifth of their previous level.
JAIDS Journal of Acquired Immune Deficiency SyndromesDetrimental Effects of Continued Illicit Drug Use on the Treatment of HIV-1 Infection
337 Citations2001Gregory M. Lucas, Laura W. Cheever +2 more
Active drug use was strongly associated with underutilization of HAART, nonadherence, and inferior virologic and immunologic responses to therapy, whereas former drug users and non-drug users were similar in all outcomes.
The LancetCD4-guided scheduled treatment interruptions compared with continuous therapy for patients infected with HIV-1: results of the Staccato randomised trial
240 Citations2006Jintanat Ananworanich, Angèle Gayet‐Ageron +25 more
Drug savings with scheduled treatment interruption were substantial, and no evidence of increased treatment resistance emerged; treatment-related adverse events were more frequent with continuous treatment, but low CD4 counts and minor manifestations of HIV infection were more frequently with scheduledreatment interruption.
Drug and Alcohol DependenceAntiretroviral adherence and HIV treatment outcomes among HIV/HCV co-infected injection drug users: The role of methadone maintenance therapy
207 Citations2006Anita Palepu, Mark Tyndall +6 more
Among HIV/HCV co-infected IDUs on HAART, enrollment in MMT was associated with reduced heroin use, and improved adherence, HIV-1 RNA suppression and CD4 cell count response.
AIDSTime to initiating highly active antiretroviral therapy among HIV-infected injection drug users
191 Citations2001David D. Celentano, Noya Galai +5 more
American Journal of EpidemiologyLongitudinal Patterns of Drug Injection Behavior in the ALIVE Study Cohort,1988-2000: Description and Determinants
182 Citations2003Noya Galai
The observed long-term injection patterns are consistent with the view of drug addiction as a chronic disease and emphasize the need for prolonged efforts to sustain cessation and to prevent adverse health and social outcomes among injection drug users.
American Journal of EpidemiologyIllicit Drug Use and HIV-1 Disease Progression: A Longitudinal Study in the Era of Highly Active Antiretroviral Therapy
175 Citations2006Gregory M. Lucas, Michael Griswold +4 more
Effectively targeting and treating active substance abuse in HIV treatment settings may provide a mechanism to improve clinical outcomes.
PubMedInterruption and discontinuation of highly active antiretroviral therapy in the multicenter AIDS cohort study.
113 Citations2005Xiuhong Li, Joseph B. Margolick +5 more
Host characteristics play a role in short interruptions, whereas longer interruptions may be clinically indicated; these longer stoppages had further virologic and immunologic consequences, however.
The American Journal of Drug and Alcohol AbuseImpact of Drug Abuse Treatment Modalities on Adherence to ART/HAART Among a Cohort of HIV Seropositive Women
91 Citations2008Farzana Kapadia, David Vlahov +9 more
Drug abuse treatment programs, irrespective of modality, are associated with improved adherence to antiretroviral therapies among drug users and concerted efforts to enroll individuals with drug use histories in treatment programs are warranted.
American Journal of EpidemiologyEffectiveness of Highly Active Antiretroviral Therapy among Injection Drug Users with Late-Stage Human Immunodeficiency Virus Infection
55 Citations2005David Vlahov, Noya Galai +5 more
Survival in the HAART era was shown by multivariate analysis to be improved for both those who did and did not receive HAART, suggesting that changing indications for treatment may have contributed to improved survival and that analyses restricted to theHAART era probably underestimate HAART effectiveness.
JAIDS Journal of Acquired Immune Deficiency SyndromesInterruption of Highly Active Antiretroviral Therapy in HIV Clinical Practice
51 Citations2005Antonella d’Arminio Monforte, Alessandro Cozzi‐Lepri +10 more
TI occurring in clinical practice is associated with an increased risk of clinical progression; hence, it should be discouraged outside strictly experimental settings.
AIDSImpact of occasional short interruptions of HAART on the progression of HIV infection: results from a cohort study
48 Citations2002Patrick Taffé, Martin Rickenbach +8 more
The results suggest that interruptions might be non-risky, particularly when viraemia is low and CD4 cell count is high, particularly in patients having initiated highly active antiretroviral therapy (HAART).
AIDS CareEarly immunologic and virologic responses to highly active antiretroviral therapy and subsequent disease progression among HIV-infected injection drug users
34 Citations2007Shruti H. Mehta, Gregory M. Lucas +4 more
AIDS Research and TherapyInjection drug use and patterns of highly active antiretroviral therapy use: an analysis of ALIVE, WIHS, and MACS cohorts
26 Citations2007John D. Morris, Elizabeth T. Golub +3 more
It is demonstrated that injection drug use by itself does not appear to be an independent risk factor for HAART switching or discontinuation in more recent years, as continued HAART use is of paramount importance for long-term control of HIV infection, efforts to improve maintenance to therapy among disadvantaged and minority populations remain greatly needed.
Cochrane Database of Systematic ReviewsStructured treatment interruptions (STI) in chronic unsuppressed HIV infection in adults
22 Citations2006Nitika Pant Pai, Jody Lawrence +2 more
This systematic review summarized the evidence on the effect of structured treatment interruptions in adult patients with chronic unsuppressed HIV infection and identified unpublished research, abstracts and ongoing trials conducted in HIV-infected patients worldwide from January 1996 to February 2006.
Clinical Infectious DiseasesImproving Survival among HIV-Infected Injection Drug Users: How Should We Define Success?
9 Citations2007Gregory D. Kirk, David Vlahov
Evidence is provided that the duration of survival among HIV-infected IDUs in Barcelona, Spain, has improved during the HAART era, and the study reinforces the fact that HIV treatments are indeed effective among IDUs, and it highlights the discrepant results observed in comparisons of the effectiveness of HAART among IDU and non-IDU populations.
