title: Increased human immunodeficiency virus loads in active methamphetamine users are explained by reduced effectiveness of antiretroviral therapy.
abstract: Abuse of methamphetamine (METH) is a frequent comorbidity among individuals infected with human immunodeficiency virus (HIV) type 1. In cell cultures and animal models, METH accelerates retroviral replication. To determine whether METH increases HIV replication in humans, we evaluated HIV loads in HIV-positive METH users and nonusers. We studied 3 groups: Tox+, active METH use and positive urine toxicology results; METH(+)Tox-, previous METH dependence/abuse and negative urine toxicology results; METH(-)Tox-, no METH dependence/abuse and negative urine toxicology results. Tox+ subjects' plasma virus loads were significantly higher than METH(+)Tox- and METH(-)Tox- subjects'; cerebrospinal fluid virus loads showed a similar but nonsignificant trend. Stratification by use of highly active antiretroviral therapy (HAART) revealed that virus loads were higher only in those Tox+ subjects who reported receiving HAART. In contrast, abstinent former METH abusers (METH(+)Tox-) receiving HAART effectively suppressed viral replication. These data suggest that abstinence programs are a key component of effective treatment of HIV in METH-abusing populations.
authors.affiliation: Department of Neurosciences, University of California San Diego, San Diego, California, USA. roellis@ucsd.edu
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Ellis
authors.forename: Meredith E
authors.initials: ME
authors.lastname: Childers
authors.forename: Mariana
authors.initials: M
authors.lastname: Cherner
authors.forename: Deborah
authors.initials: D
authors.lastname: Lazzaretto
authors.forename: Scott
authors.initials: S
authors.lastname: Letendre
authors.forename: Igor
authors.initials: I
authors.lastname: Grant
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D002140:California / Q000453:epidemiology; D000697:Central Nervous System Stimulants; D015897:Comorbidity; D005260:Female; D006679:HIV Seropositivity / Q000134:cerebrospinal fluid / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008694:Methamphetamine; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood / Q000134:cerebrospinal fluid; D020133:Reverse Transcriptase Polymerase Chain Reaction; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D019562:Viral Load; D014779:Virus Replication / Q000187:drug effects
chemical_list: D019380:Anti-HIV Agents; D000697:Central Nervous System Stimulants; D012367:RNA, Viral; D008694:Methamphetamine