title: Illicit drug use and HIV treatment outcomes in a US cohort.
abstract: OBJECTIVE
  To determine the prevalence of illicit drug use and the impact on HIV treatment.
  
  
  METHODS
  Multivariable regression of cross-sectional data from 1163 HIV-infected and 294 controls from the Study of Fat Redistribution and Metabolic Change in HIV Infection (FRAM).
  
  
  METHODS
  An analysis of (1) prevalence of specific illicit drug use (ever, current), (2) being on HAART among those with an indication and (3) current HIV RNA and CD4 cell count among HAART users.
  
  
  RESULTS
  Median age was 42 years, approximately 50% were non-Caucasian and 33% were women. Eighty-six percent of HIV-infected and 67% of controls reported ever using illicit drugs (P < 0.0001); 28% of HIV-infected and 16% of controls reported current use (P = 0.0001). In adjusted models, current cocaine use and past heroin use were associated with not currently being on HAART. Among HAART users, those reporting past heroin use were as likely to have an undetectable HIV viral load as those who had never used heroin. Current and past cocaine use and current heroin use was associated with lower odds of undetectable HIV RNA. Past amphetamine use was associated with having an undetectable HIV. Similar results were seen for CD4 lymphocyte counts.
  
  
  CONCLUSIONS
  Illicit drug use in the US is common, although far fewer report current use than past use. Among HIV-infected patients, understanding of the type of illicit drugs used and whether drug use was in the past or ongoing is important, because of their differential effects on HIV treatment outcomes.
authors.affiliation: Johns Hopkins School of Medicine, Department of Medicine, Baltimore, Maryland, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Cofrancesco
authors.forename: Rebecca
authors.initials: R
authors.lastname: Scherzer
authors.forename: Phyllis C
authors.initials: PC
authors.lastname: Tien
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Gibert
authors.forename: Heather
authors.initials: H
authors.lastname: Southwell
authors.forename: Stephen
authors.initials: S
authors.lastname: Sidney
authors.forename: Adrian
authors.initials: A
authors.lastname: Dobs
authors.forename: Carl
authors.initials: C
authors.lastname: Grunfeld
mesh_terms: D000328:Adult; D000662:Amphetamines; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D019970:Cocaine-Related Disorders / Q000150:complications / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006556:Heroin Dependence / Q000150:complications / Q000453:epidemiology; D006801:Humans; D013287:Illicit Drugs; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D019966:Substance-Related Disorders / Q000150:complications* / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D019562:Viral Load
chemical_list: D000662:Amphetamines; D013287:Illicit Drugs