Adherence to antiretroviral therapy in HIV-infected persons with opioid dependence receiving naltrexone treatment course
Year: 2025
Type: article
Abstract: Introduction. Optimal adherence to antiretroviral therapy (ART) is a key factor in achieving an undetectable HIV viral load (HIV VL). Among people with opioid use disorder (OUD), it is insufficient to suppress viremia. Treatment of OUD helps to increase the adherence and effectiveness of ART and HIV outcomes. The objective was to evaluate the adherence to ART in patients with HIV and OUD treated with naltrexone in oral or implantable formulations, and to compare the data obtained using the Adherence Assessment Questionnaire (AAQ), Electronic Monitoring of Treatment (EMT), and dynamic of HIV VL. Methods and materials . 200 patients with HIV infection (IV A-IV B) with OUD who completed a course of detoxification were divided into two groups (100 in each), where they received oral (ON) or implantable (IN) naltrexone treatment for 48 weeks simultaneously with ART. Outcomes of ART adherence: 1) adherence index (AI) (based on AAQ data); 2) EMT – the ratio of the number of actual openings to the number of openings to be made («correct openings»); 3) dynamic of the HIV VL level. Results. ART adherence to AI and EMT is significantly higher in patients who completed treatment with naltrexone compared with those who discontinued the treatment earlier (92.4±15.17 vs. 89.32±21.33, p<0.001 and 73.3±22.0 % vs. 65.10±32.1 %, p=0.038, respectively). A significant correlation was found between AI and EMT (r=0.78, p=0.0001); and moderate for each method with the difference in HIV VL in dynamic (AI, r=0.306, p=0.0002; EMT, r=0.305, p=0.0002). Conclusion. The stabilization of OUD remission helps to increase the ART adherence and improve the HIV outcomes. The results demonstrate the consistency of the objective and subjective methods for assessing ART adherence in patients with HIV and OUD.
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4417506155