Evaluating supervised HAART in late-stage HIV among drug users: a preliminary report.
OBJECTIVE
To examine response to highly active antiretroviral therapy (HAART) among a sample of treatment-experienced patients in the late stage of human immunodeficiency virus (HIV) infection in residential health care facilities (RHCFs) in New York City facilities designated for HIV/AIDS (acquired immunodeficiency syndrome) when access and adherence are maximized.


METHODS
Medical record review of 111 patients.


RESULTS
Demographics were mean age 42 years; 58% male; 60% African-American; 31% Hispanic; 57% injection drug users (IDUs); 23% with history of dementia; 52% hepatitis C virus (HCV) antibody seropositive; 80% on HAART, of whom 18% had lipodystrophy. Of 88 patients on HAART, 52% had a decreased viral load (>1/2 log) versus 13% of 23 not on HAART (P<.05); a >1/2 log viral load increase was seen in 8% and 35%, respectively (P<.05). Those with viral load increase were more likely than those with stable/decreased viral load to be IDUs (71% vs. 64%) and to have HCV seropositivity (86% vs. 53%), even with similar initial CD4+ cell count, viral load, and follow-up time.


CONCLUSIONS
In a predominantly minority IDU population who are treatment experienced, 50% of the patients successfully responded to treatment with supervised therapy. The RHCFs in New York City provide a unique opportunity to examine further factors associated with response to HAART in an environment in which medication administration and adherence are maximized and monitored carefully.
Greenberg
B
B
New York Academy of Medicine, Office of Special Population/Center for Urban Epidemiologic Studies, NY 10029, USA. bgreenberg@nyam.org
Berkman
A
A
Thomas
R
R
Hoos
D
D
Finkelstein
R
R
Astemborski
J
J
Vlahov
D
D
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D020276:HIV Long-Term Survivors; D006801:Humans; D008297:Male; D008499:Medical Records; D009519:New York City; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015819:Substance Abuse, Intravenous / Q000150:complications*; D016896:Treatment Outcome; D019562:Viral Load
D019380:Anti-HIV Agents