title: Correlates of HIV-1 viral suppression in a cohort of HIV-positive drug users receiving antiretroviral therapy in Hanoi, Vietnam.
abstract: Injection drug users bear the burden of HIV in Vietnam and are a focus of national treatment programmes. To date, determinants of successful therapy in this population are unknown. Substance use and clinical correlates of viral suppression were studied in 100 HIV-1-infected drug users receiving antiretroviral therapy (ART) for at least six months in Hanoi, Vietnam. The mean age of the cohort was 29.9 + 4.9 years; all were men. A majority of patients (73%) achieved viral suppression (HIV-RNA <1000 copies/mL). Correlates of viral suppression include self-reported > or = 95% adherence (P < 0.01) and current use of trimethoprim/sulphamethoxazole (P < 0.01); current or ever diagnosed with tuberculosis was associated with viral non-suppression (P = 0.006). Tobacco use was prevalent (84%), and surprisingly 48% of patients reported active drug use; neither was associated with viral non-suppression. This is the first study to document successful ART treatment in a population of Vietnamese drug users; rates of viral suppression are comparable to other international populations. The 28% of patients without HIV-1 suppression highlight the need for adherence promotion, risk reduction programmes, and population-based surveillance strategies for assessing the emergence of HIV drug resistance in settings where access to viral load and drug resistance testing is limited.
authors.affiliation: Tufts Medical Center, Division of Geographic Medicine and Infectious Disease, Boston, MA 02111, USA. mjordan@tuftsmedicalcenter.org
authors.forename: M R
authors.initials: MR
authors.lastname: Jordan
authors.forename: H
authors.initials: H
authors.lastname: La
authors.forename: H D
authors.initials: HD
authors.lastname: Nguyen
authors.forename: H
authors.initials: H
authors.lastname: Sheehan
authors.forename: T T M
authors.initials: TT
authors.lastname: Lien
authors.forename: D V
authors.initials: DV
authors.lastname: Duong
authors.forename: J
authors.initials: J
authors.lastname: Hellinger
authors.forename: C
authors.initials: C
authors.lastname: Wanke
authors.forename: A M
authors.initials: AM
authors.lastname: Tang
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology / Q000627:therapeutic use; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D055030:Drug Users / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D008297:Male; D010349:Patient Compliance; D018894:Reverse Transcriptase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D019966:Substance-Related Disorders / Q000150:complications* / Q000453:epidemiology; D016896:Treatment Outcome; D014744:Vietnam / Q000453:epidemiology; D019562:Viral Load; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors