Substance use Patterns and HIV-1 RNA Viral Load Rebound among HIV-Positive Illicit Drug users in a Canadian Setting

Ladak, Farah; Socías, M. Eugenia; Nolan, Seonaid; Dong, Huiru; Wood, Evan; Montaner, Joan; Milloy, M‐J

doi:10.3851/imp3265

Cited by 27 publications

(13 citation statements)

References 38 publications

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“…Second, they demonstrate that a history of viremia due to NTIs may have lasting effects on the size of the reservoir, and as such, virologic history should be considered when designing or analyzing HIV-1 cure studies. We and others have clearly documented how illicit drug use, particularly the intensity of injecting drugs, is directly associated with the inability of PWID to maintain durable HIV-1 viral suppression [15,30,33]. Our data indicate that injecting drugs is more likely to impact latent reservoir size through behavioral mechanisms resulting in repeated loss of viral suppression in contrast to biological effects of the illicit drugs themselves.…”

Section: Discussionmentioning

confidence: 59%

Nonstructured Treatment Interruptions Are Associated With Higher Human Immunodeficiency Virus Reservoir Size Measured by Intact Proviral DNA Assay in People Who Inject Drugs

Kirk

Astemborski

Mehta

et al. 2020

The Journal of Infectious Diseases

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The latent reservoir for HIV-1 in CD4 + T cells is a major barrier to cure. HIV-1-infected persons who inject drugs (PWID) often struggle to maintain suppression of viremia and experience non-structured treatment interruptions (NTIs). The effects of injecting drugs or NTIs on the reservoir are unclear. Using the intact proviral DNA assay (IPDA), we found no apparent effect of heroin or cocaine use on reservoir size. However, we found significantly larger reservoirs in those with frequent NTIs or a shorter interval from last detectable HIV RNA measurement. These results have important implications for inclusion of PWID in HIV-1 cure studies.

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Section: Discussionmentioning

confidence: 59%

Nonstructured Treatment Interruptions Are Associated With Higher Human Immunodeficiency Virus Reservoir Size Measured by Intact Proviral DNA Assay in People Who Inject Drugs

Kirk

Astemborski

Mehta

et al. 2020

The Journal of Infectious Diseases

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“…9,13,25 Depression, poor mental health, and illicit substance use in turn predict ART nonadherence, higher viral loads, CD4 + T lymphocyte count decline, increased probability of AIDSdefining illness, and AIDS-related mortality. 9,[26][27][28][29][30] FIG. 1.…”

Section: Mental Health Pathsmentioning

confidence: 99%

Mechanisms from Food Insecurity to Worse HIV Treatment Outcomes in US Women Living with HIV

Weiser

Sheira

Palar

et al. 2020

AIDS Patient Care and STDs

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Food insecurity (FI) contributes to HIV-related morbidity and mortality, but the mechanisms whereby FI negatively impacts HIV health are untested. We tested the hypothesis that FI leads to poor HIV clinical outcomes through nutritional, mental health, and behavioral paths. We analyzed data from Women's Interagency HIV Study (WIHS) among 1803 women living with HIV (WLWH) (8225 person-visits) collected from 2013 to 2015 biannually from nine sites across the United States participating in the WIHS. FI was measured with the US Household Food Security Survey Module. Outcomes included HIV viral nonsuppression, CD4 cell counts, and physical health status (PHS). We used longitudinal logistic and linear regression models with random effects to examine associations adjusting for covariates and path analysis to test nutritional, mental health, and behavioral paths. Increasing severity of FI was associated with unsuppressed viral load, lower CD4 counts, and worse PHS (all p < 0.05). Report of FI 6 months earlier was independently associated with most outcomes after adjusting for concurrent FI. For viral nonsuppression, the nutritional and behavioral paths accounted for 2.09% and 30.66% of the total effect, with the mental health path operating via serial mediation through the behavioral path. For CD4 count, the mental health and behavioral paths accounted for 15.21% and 17.0% of the total effect, respectively. For PHS, depressive symptoms accounted for 60.2% of the total effect. In conclusion, FI is associated with poor health among WLWH through different paths depending on the outcome. Interventions should target FI and its behavioral and mental health mechanisms to improve HIV outcomes.

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“…Exclusively for HIV, patients with longer use of illicit drugs were more likely to have a high viral load. Specifically, we noted that most users used cocaine or marijuana, which are associated with effects on the immune system indicative of compromised resistance to HIV 127 , which favors not only the risk of infection but also intensive therapeutic control 128 . We suggest that the continued use of these illicit drugs may be conducive to both the acquisition and progression of infection because the time of initiation of HAART was not associated with viral load, which points to a complex interaction between illicit drug use and virological activity, which may be as significant as exposure to therapy 129 .…”

Section: Discussionmentioning

confidence: 99%

Epidemiological risk factors associated with primary infection by Epstein–Barr virus in HIV-1-positive subjects in the Brazilian Amazon region

Pereira

França

Costa

et al. 2021

Sci Rep

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To identify the prevalence and risk factors for primary Epstein–Barr virus (EBV) infection in human immunodeficiency virus (HIV)-1-positive adult treatment-naïve patients between January 2018 and December 2019 in a state of the Brazilian Amazon region. A total of 268 HIV-1 positive patients and 65 blood donors participated in the study. Epidemiological data were obtained from medical records and through a designed questionnaire. EBV infection was screened by the semiquantitative detection of anti-viral capsid antigen (VCA) EBV IgM and IgG, followed by molecular detection of the EBNA-3C gene. The plasma viral loads of HIV-1 and EBV were quantified using a commercial kit. The prevalence of primary coinfection was 7.12%. The associated risk factors were education level, family income, history of illicit drug use and sexually transmitted infections, homosexual contact and condom nonuse. Approximately 58.5% had late initiation of highly active antiretroviral therapy, which influenced the risk of HIV-EBV 1/2 multiple infection (odds ratio (OR): 4.76; 95% CI 1.51–15.04) and symptom development (p = 0.004). HIV viral load was associated with patient age (OR: 2.04; 95% CI 2.01–2.07; p = 0.026) and duration of illicit drug use (OR: 1.57; 95% CI 1.12–2.22; p = 0.0548). EBV viral load was associated with younger age (OR: 0.82; 95% CI 0.79–1.03; p = 0.0579). The replication of both viruses was associated with symptom development (HIV = OR: 2.06; 95% CI 1.22–3.50; p = 0.0073; EBV = OR: 8.81; 95% CI 1–10; p = 0.0447). The prevalence of HIV/EBV coinfection was lower than that observed in other studies, and social vulnerability and promiscuous sexual behavior were associated risk factors. A long time of HIV-1 infection, without therapy, influenced the risk of coinfection and disease progression. The viral loads of both viruses may be associated with some epidemiological aspects of the population.

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Substance use Patterns and HIV-1 RNA Viral Load Rebound among HIV-Positive Illicit Drug users in a Canadian Setting

Cited by 27 publications

References 38 publications

Nonstructured Treatment Interruptions Are Associated With Higher Human Immunodeficiency Virus Reservoir Size Measured by Intact Proviral DNA Assay in People Who Inject Drugs

Nonstructured Treatment Interruptions Are Associated With Higher Human Immunodeficiency Virus Reservoir Size Measured by Intact Proviral DNA Assay in People Who Inject Drugs

Mechanisms from Food Insecurity to Worse HIV Treatment Outcomes in US Women Living with HIV

Epidemiological risk factors associated with primary infection by Epstein–Barr virus in HIV-1-positive subjects in the Brazilian Amazon region

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