title: Low Non-structured Antiretroviral Therapy Interruptions in HIV-Infected Persons Who Inject Drugs Receiving Multidisciplinary Comprehensive HIV Care at an Outpatient Drug Abuse Treatment Center.
abstract: Continuous HIV treatment is necessary to ensure successful combined antiretroviral therapy (cART). The aim of this study was to evaluate the incidence of patient-initiated non-structured treatment interruptions in HIV-infected persons who inject drugs and who received a multidisciplinary comprehensive program, including medical HIV care, drug-dependence treatment and psychosocial support, at a drug outpatient addiction center. Non-structured treatment interruptions were defined as ≥30 consecutive days off cART without medical indication. During a median follow-up of 53.8 months, 37/132 (28 %) patients experienced the first non-structured treatment interruptions. The cumulative probability of cART interruption at 5 years was 31.2 % (95 % CI 22.4-40.0). Current drug use injection ≥1/day (HR 14.77; 95 % CI 5.90-36.96) and cART naive patients (HR 0.35, 95 % CI 0.14-0.93) were predictive factors for non-structured treatment interruptions. HIV care provided at a drug addiction center is a useful strategy to sustain continuous cART, however, drug abstinence is essential for the long-term maintenance of cART.
authors.affiliation: Institute of Neuropsychiatry and Addictions, Universitat Autònoma de Barcelona, Parc de Salut Mar, Barcelona, Spain. 91773@parcdesalutmar.cat.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Vallecillo
authors.affiliation: Department of Statistics and Operations Research, Parc de Recerca Biomédica de Barcelona PRBB, Barcelona, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Mojal
authors.affiliation: Institute of Neuropsychiatry and Addictions, Universitat Autònoma de Barcelona, Parc de Salut Mar, Barcelona, Spain.
authors.forename: Albert
authors.initials: A
authors.lastname: Roquer
authors.affiliation: Institute of Neuropsychiatry and Addictions, Universitat Autònoma de Barcelona, Parc de Salut Mar, Barcelona, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Samos
authors.affiliation: Department of Pharmacy, Hospital del Mar., Barcelona, Spain.
authors.forename: Sonia
authors.initials: S
authors.lastname: Luque
authors.affiliation: Institute of Neuropsychiatry and Addictions, Universitat Autònoma de Barcelona, Parc de Salut Mar, Barcelona, Spain.
authors.forename: Diana
authors.initials: D
authors.lastname: Martinez
authors.affiliation: Institute of Neuropsychiatry and Addictions, Universitat Autònoma de Barcelona, Parc de Salut Mar, Barcelona, Spain.
authors.forename: Paula Karen
authors.initials: PK
authors.lastname: Martires
authors.affiliation: Institute of Neuropsychiatry and Addictions, Universitat Autònoma de Barcelona, Parc de Salut Mar, Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Torrens
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology / Q000821:virology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D008875:Middle Aged; D058850:Opiate Substitution Treatment / Q000706:statistics & numerical data*; D010045:Outpatients; D013030:Spain / Q000453:epidemiology; D016320:Substance Abuse Treatment Centers; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D008691:Methadone
keywords: Antiretroviral; Drugs; HIV; Interruptions; Therapy