title: Improved quality of life for opioid-dependent patients receiving buprenorphine treatment in HIV clinics.
abstract: BACKGROUND
  Opioid dependence and HIV infection are associated with poor health-related quality of life (HRQOL). Buprenorphine/naloxone (bup/nx) provided in HIV care settings may improve HRQOL.
  
  
  METHODS
  We surveyed 289 HIV-infected opioid-dependent persons treated with clinic-based bup/nx about HRQOL using the Short Form Health Survey (SF-12) administered at baseline, 3, 6, 9, and 12 months. We used normalized SF-12 scores, which correspond to a mean HRQOL of 50 for the general US population (SD 10, possible range 0-100). We compared mean normalized mental and physical composite and component scores in quarters 1, 2, 3, and 4 with baseline scores using generalized estimating equation models. We assessed the effect of clinic-based bup/nx prescription on HRQOL composite scores using mixed effects regression with site as random effect and time as repeated effect.
  
  
  RESULTS
  Baseline normalized SF-12 scores were lower than the general US population for all HRQOL domains. Average composite mental HRQOL improved from 38.3 (SE 12.5) to 43.4 (SE 13.2) [β 1.13 (95% CI: 0.72 to 1.54)] and composite physical HRQOL remained unchanged [β 0.21 (95% CI: -0.16 to 0.57)] over 12 months follow-up. Continued bup/nx treatment across all 4 quarters was associated with improvements in both physical [β 2.38 (95% CI: 0.63 to 4.12)] and mental [β 2.51 (95% CI: 0.42 to 4.60)] HRQOL after adjusting for other contributors to HRQOL.
  
  
  CONCLUSIONS
  Clinic-based bup/nx maintenance therapy is potentially effective in ameliorating some of the adverse effects of opioid dependence on HRQOL for HIV-infected populations.
authors.affiliation: Department of Medicine, Oregon Health and Science University, Portland, OR 97239-3098, USA. korthuis@ohsu.edu
authors.forename: P Todd
authors.initials: PT
authors.lastname: Korthuis
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Tozzi
authors.forename: Vijay
authors.initials: V
authors.lastname: Nandi
authors.forename: David A
authors.initials: DA
authors.lastname: Fiellin
authors.forename: Linda
authors.initials: L
authors.lastname: Weiss
authors.forename: James E
authors.initials: JE
authors.lastname: Egan
authors.forename: Michael
authors.initials: M
authors.lastname: Botsko
authors.forename: Angela
authors.initials: A
authors.lastname: Acosta
authors.forename: Marc N
authors.initials: MN
authors.lastname: Gourevitch
authors.forename: David
authors.initials: D
authors.lastname: Hersh
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Hsu
authors.forename: Joshua
authors.initials: J
authors.lastname: Boverman
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Altice
mesh_terms: D000328:Adult; D002047:Buprenorphine / Q000627:therapeutic use*; D000069479:Buprenorphine, Naloxone Drug Combination; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009270:Naloxone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment / Q000523:psychology; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000523:psychology; D011788:Quality of Life
chemical_list: D000069479:Buprenorphine, Naloxone Drug Combination; D009292:Narcotic Antagonists; D009270:Naloxone; D002047:Buprenorphine