Substance use and HIV disease progression in the HAART era: Implications for the primary prevention of HIV

Carrico, Adam W.

doi:10.1016/j.lfs.2010.10.002

Cited by 102 publications

(74 citation statements)

References 76 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Injection drug use accounts for a significant proportion of HIV-infections in Manitoba, while non-injection drug and alcohol use can result in high risk behaviours leading to the transmission of HIV and increased comorbidity 3,11 . There is evidence to suggest that substance use is a predictor of a more rapid HIV disease progression regardless of adherence to antiretroviral therapy 12 . In the context of this study, the analysis suggests that substance use is associated with female gender, residence in the core downtown area, and Aboriginal ethnicity, which may represent the vulnerability to adverse health outcomes for these populations in general.…”

Section: Discussionmentioning

confidence: 99%

Substance use and its impact on care outcomes among HIV-infected individuals in Manitoba

et al. 2015

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Substance use and its impact on care outcomes among HIV-infected individuals in Manitoba

et al. 2015

View full text Add to dashboard Cite

“…HIV-associated cognitive deficits include impairments in learning, executive functions, working memory, recall (episodic memory), processing speed, and motor skills (Heaton et al, 1995;Lindl et al, 2010). Both HIV disease progression and HIV-associated cognitive deficits may be exacerbated by comorbid drug use (Carrico, 2011). Methamphetamine dependence, in particular, is a common comorbidity of HIV infection (Marquez et al, 2009) and has been linked to increased neurocognitive impairments in HIV+ individuals (Rippeth et al, 2004;Gupta et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Methamphetamine Exposure Combined with HIV-1 Disease or gp120 Expression: Comparison of Learning and Executive Functions in Humans and Mice

Kesby

Heaton

Young

et al. 2015

Neuropsychopharmacol

View full text Add to dashboard Cite

Methamphetamine dependence is a common comorbid condition among people living with HIV, and may exacerbate HIV-associated neurocognitive disorders. Animal models of neuroAIDS suggest that the gp120 protein may also cause cognitive impairment. The present work evaluated the separate and combined effects of HIV/gp120 and methamphetamine on learning and executive functions in both humans and transgenic mice. Human participants were grouped by HIV serostatus (HIV+ or HIV − ) and lifetime methamphetamine dependence (METH+ or METH − ). A neurocognitive test battery included domain-specific assessments of learning and executive functions. Mice (gp120+ and gp120 − ) were exposed to either a methamphetamine binge (METH+) or saline (METH − ), then tested in the attentional-set-shifting task to assess learning and executive functions. In humans, HIV status was associated with significant impairments in learning, but less so for executive functions. The frequency of learning impairments varied between groups, with the greatest impairment observed in the HIV+/METH+ group. In mice, gp120 expression was associated with impairments in learning but not reversal learning (executive component). The greatest proportion of mice that failed to complete the task was observed in the gp120 +/METH+ group, suggesting greater learning impairments. Our cross-species study demonstrated that HIV in humans and gp120 in mice impaired learning, and that a history of methamphetamine exposure increased the susceptibility to HIV-associated neurocognitive deficits in both species. Finally, the similar pattern of results in both species suggest that the gp120 protein may contribute to HIV-associated learning deficits in humans.

show abstract

“…HIV-positive persons who use stimulants (e.g., methamphetamine, cocaine, and crack-cocaine) are at elevated risk for more rapid HIV disease progression, 1–4 though the underlying biological or behavioral mechanisms for this disturbance have not been clearly elucidated. 5–10 There is evidence that substance users are less likely to access highly active anti-retroviral therapy (HAART), 11 , 12 and stimulant users initiate HAART at lower T-helper (CD4+) cell counts than their peers who do not use substances.…”

Section: Introductionmentioning

confidence: 99%

Stimulant Use and Progression to AIDS or Mortality After the Initiation of Highly Active Antiretroviral Therapy

Carrico

Shoptaw

Cox

et al. 2014

JAIDS Journal of Acquired Immune Deficiency Syndromes

Self Cite

View full text Add to dashboard Cite

Background HIV-positive persons who use stimulants (e.g., methamphetamine) experience profound health disparities, but it remains unclear if these persist after highly active anti-retroviral therapy (HAART) initiation. Conducted within the Multicenter AIDS Cohort Study, this investigation examined if stimulant use is associated with progression to AIDS or all-cause mortality after the initiation of HAART. Methods Using marginal structural modeling, the cumulative proportion of visits where any stimulant use was reported (i.e., 0%, 1 – 49%, 50 – 99%, and 100%) was examined as a time-varying predictor of: 1) all-cause mortality; and 2) AIDS or all-cause mortality. Results Among the 1,313 men who have sex with men (MSM) who initiated HAART, findings showed no significant association of any level of stimulant use with all-cause mortality. A competing risks analysis indicated that no level of stimulant use was associated with increased AIDS-related or non-AIDS mortality separately. Among the 648 participants without AIDS at HAART initiation, a secondary analysis indicated that stimulant use at 50% or more of study visits was associated with a 1.5-fold increase in the odds of progression to AIDS or all-cause mortality (Adjusted OR = 1.54; 95% CI = 1.02 – 2.33, p < .05). Conclusions HIV-positive, stimulant-using MSM receiving HAART appear to face no greater overall risks for all-cause, AIDS-related, or non-AIDS mortality compared to non-users. However, men without AIDS at HAART initiation who more frequently reported stimulant use demonstrated modestly increased odds of progression to AIDS or all-cause mortality. Comprehensive approaches are needed to optimize the effectiveness of HAART with stimulant-using MSM.

show abstract

Substance use and HIV disease progression in the HAART era: Implications for the primary prevention of HIV

Cited by 102 publications

References 76 publications

Substance use and its impact on care outcomes among HIV-infected individuals in Manitoba

Substance use and its impact on care outcomes among HIV-infected individuals in Manitoba

Methamphetamine Exposure Combined with HIV-1 Disease or gp120 Expression: Comparison of Learning and Executive Functions in Humans and Mice

Stimulant Use and Progression to AIDS or Mortality After the Initiation of Highly Active Antiretroviral Therapy

Contact Info

Product

Resources

About