title: Self-reported side effects in buprenorphine and methadone patients receiving antiretroviral therapy: results from the MANIF 2000 cohort study.
abstract: OBJECTIVE
  The aim of the study was to investigate the relationship between methadone and buprenorphine treatment and self-reported symptoms in HIV-infected opioid dependent individuals receiving antiretroviral therapy (ART).
  
  
  METHODS
  Longitudinal study.
  
  
  METHODS
  The French MANIF2000 cohort was used to compare self-reported symptoms in buprenorphine and methadone patients also receiving ART.
  
  
  METHODS
  We selected individuals receiving ART and OAT (342 visits among 106 patients).
  
  
  METHODS
  Symptoms were self-reported using a list of 14 symptoms (e.g. nausea, fatigue, fever) perceived during the previous 4 weeks, including three painful symptoms (abdominal or muscular pain, headaches). A two-step Heckman approach enabled us to account for the non-random assignment of OAT: a probit model identified predictors of starting either buprenorphine or methadone. A Poisson regression based on generalized estimating equations (GEE) was then used to identify predictors of the number of symptoms while adjusting for the non-random assignment of OAT.
  
  
  RESULTS
  The median (interquartile range) number of symptoms was 4 (1-6) and 2 (1-6) among buprenorphine and methadone patients, respectively. After adjustment for non-random assignment of OAT type, depressive and opioid withdrawal symptoms, anxiolytics consumption and daily cannabis use, methadone patients were more likely to report a lower number of symptoms than those receiving buprenorphine.
  
  
  CONCLUSIONS
  Methadone patients on ART report fewer symptoms than buprenorphine patients on ART under current treatment conditions in France. Further experimental research is still needed to identify an OAT-ART strategy which would minimize the burden of self-reported symptoms and potential interactions, while assuring sustainability and response to both treatments.
authors.affiliation: NSERM, U912 (SE4S), Marseille, France Université Aix Marseille, IRD, UMR-S912, Marseille, France. pmcarrieri@aol.com
authors.forename: M Patrizia
authors.initials: MP
authors.lastname: Carrieri
authors.forename: Perrine
authors.initials: P
authors.lastname: Roux
authors.forename: Julien
authors.initials: J
authors.lastname: Cohen
authors.forename: Isabelle
authors.initials: I
authors.lastname: Ravaux
authors.forename: Pierre
authors.initials: P
authors.lastname: Dellamonica
authors.forename: Camelia
authors.initials: C
authors.lastname: Protopopescu
authors.forename: Bruno
authors.initials: B
authors.lastname: Spire
authors.forename: Andrew
authors.initials: A
authors.lastname: Rosenblum
mesh_terms: D044966:Anti-Retroviral Agents / Q000009:adverse effects*; D001294:Attitude to Health; D002047:Buprenorphine / Q000627:therapeutic use*; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology; D005260:Female; D005602:France; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006297:Health Services Accessibility; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D055118:Medication Adherence; D008691:Methadone / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000150:complications / Q000188:drug therapy*; D010146:Pain / Q000188:drug therapy / Q000453:epidemiology; D057566:Self Report; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000188:drug therapy; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D044966:Anti-Retroviral Agents; D002047:Buprenorphine; D008691:Methadone