title: Methadone maintenance therapy decreases the rate of antiretroviral therapy discontinuation among HIV-positive illicit drug users.
abstract: We sought to examine whether methadone maintenance therapy (MMT) decreased rates of antiretroviral therapy (ART) discontinuation and was associated with plasma HIV RNA responses among a cohort of illicit drug users. Cumulative ART discontinuation rates were estimated using Kaplan-Meier methods and factors independently associated with ART discontinuation were identified using Cox proportional hazards regression. Engagement in MMT was negatively and independently associated with ART discontinuation [Adjusted Relative Hazard = 0.67 (95 % CI 0.54-0.83); p < 0.001]. Among participants receiving ART and MMT, 81.6 % of plasma HIV-1 RNA assessments were <500 copies/mL, while 65.81 % of HIV-1 RNA assessments among those prescribed ART without MMT were <500 copies/mL (p < 0.001). These results demonstrate that engagement in MMT conferred a protective benefit against ART discontinuation and was associated with a significant increase in plasma HIV RNA suppression among HIV-infected opioid-dependent drug users.
authors.affiliation: Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, University of British Columbia, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
authors.forename: H
authors.initials: H
authors.lastname: Reddon
authors.forename: M-J
authors.initials: MJ
authors.lastname: Milloy
authors.forename: A
authors.initials: A
authors.lastname: Simo
authors.forename: J
authors.initials: J
authors.lastname: Montaner
authors.forename: E
authors.initials: E
authors.lastname: Wood
authors.forename: T
authors.initials: T
authors.lastname: Kerr
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D018791:CD4 Lymphocyte Count; D002170:Canada / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D053208:Kaplan-Meier Estimate; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D008875:Middle Aged; D058850:Opiate Substitution Treatment; D015397:Program Evaluation; D011446:Prospective Studies; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D016896:Treatment Outcome; D019562:Viral Load; D016903:Drug Monitoring
chemical_list: D000701:Analgesics, Opioid; D019380:Anti-HIV Agents; D013287:Illicit Drugs; D008691:Methadone
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