Association between recent methamphetamine use, antiretroviral therapy and HIV viral load; a mediation analysis from a cohort of HIV positive persons who inject drugs in Hai Phong, Vietnam.

Autor:	Feelemyer J; Department of Population Health, 12296New York University School of Medicine, New York, NY, USA., Des Jarlais D; 5894New York University College of Global Public Health, New York, NY, USA., Nagot N; Pathogenesis & Control of Chronic and Emerging Infections, 27037University of Montpellier, INSERM, Antilles University, Montpellier, France., Duong Thi H; 344670Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam., Thi Hai OK; Supporting Community Development Initiatives, Hanoi, Vietnam., Pham Minh K; 344670Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam., Hoang Thi G; 344670Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam., Nham Thi Tuyet T; Supporting Community Development Initiatives, Hanoi, Vietnam., Cleland CM; Department of Population Health, 12296New York University School of Medicine, New York, NY, USA., Arasteh K; 5894New York University College of Global Public Health, New York, NY, USA., Caniglia E; Perelman School of Medicine, 14640University of Pennsylvania, Philadelphia PA, USA., Chen Y; Department of Population Health, 12296New York University School of Medicine, New York, NY, USA., Bart G; Department of Medicine, 311816University of Minnesota, Minneapolis, USA., Moles JP; Pathogenesis & Control of Chronic and Emerging Infections, 27037University of Montpellier, INSERM, Antilles University, Montpellier, France., Vu Hai V; Department of Infectious and Tropical Diseases, Viet Tiep Hospital, Haiphong, Vietnam., Vallo R; Pathogenesis & Control of Chronic and Emerging Infections, 27037University of Montpellier, INSERM, Antilles University, Montpellier, France., Quillet C; Pathogenesis & Control of Chronic and Emerging Infections, 27037University of Montpellier, INSERM, Antilles University, Montpellier, France., Rapoud D; Pathogenesis & Control of Chronic and Emerging Infections, 27037University of Montpellier, INSERM, Antilles University, Montpellier, France., Sao ML; 344670Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam., Michel L; Pierre Nicole Center, 55327French Red Cross, CESP/Inserrm, Paris, France., Laureillard D; Pathogenesis & Control of Chronic and Emerging Infections, 27037University of Montpellier, INSERM, Antilles University, Montpellier, France.; Infectious Diseases Department, 55112Caremeau University Hospital, Nîmes, France., Khan MR; Department of Population Health, 12296New York University School of Medicine, New York, NY, USA.
Jazyk:	angličtina
Zdroj:	International journal of STD & AIDS [Int J STD AIDS] 2023 Mar; Vol. 34 (4), pp. 236-244. Date of Electronic Publication: 2023 Jan 13.
DOI:	10.1177/09564624221142366
Abstrakt:	Background: There has been a significant increase in methamphetamine use among persons who use drugs in Vietnam in the last 5-10 years. We examined the degree to which adherence to antiretroviral therapy (ART) mediates the relationship between recent methamphetamine use and unsuppressed HIV viral load among people who inject drugs (PWID) in Hai Phong, Vietnam. Methods: We recruited PWID from October 2016-October 2018 and enrolled HIV positive PWID into a cohort, with up to three years of total follow-up. We assessed relationships among recent methamphetamine use frequency, ART adherence and unsuppressed HIV viral load. Mediation analysis was used to estimate the total and natural direct effects of recent methamphetamine use on unsuppressed HIV viral load and the indirect effect proportion. Results: We enrolled 792 HIV seropositive PWID into the cohort; approximately 75.9% reported high/perfect ART adherence at baseline and 81.3% were virally suppressed. In mediation analysis, the total effect for the association between methamphetamine use and unsuppressed HIV viral load (1000 copies/mL) was 3.94 (95% CI: 1.95, 7.96); the natural direct effect was 2.14 (95% CI: 1.29, 3.55); the proportion mediated by self-reported ART adherence was 0.444. Similar results were found when examining lower unsuppressed HIV viral load cutpoints of 250 copies/mL and 500 copies/mL. Conclusions: Methamphetamine use is associated with unsuppressed HIV viral load among PWID despite high levels of ART adherence. Further research is needed to better understand these relationships, with emphasis on potential biological pathways that may interact with ART.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu