Accumulation of HIV-1 Drug Resistance Mutations and Methamphetamine Use.
HIV
antiretroviral therapy
drug resistance
methamphetamines.
mutations
treatment adherence
Journal
Current HIV research
ISSN: 1873-4251
Titre abrégé: Curr HIV Res
Pays: Netherlands
ID NLM: 101156990
Informations de publication
Date de publication:
2021
2021
Historique:
received:
01
02
2021
revised:
03
05
2021
accepted:
17
05
2021
pubmed:
29
6
2021
medline:
3
5
2022
entrez:
28
6
2021
Statut:
ppublish
Résumé
Antiretroviral therapy (ART) non-adherence and methamphetamine use are associated with higher HIV drug resistance prevalence. How they affect drug resistance mutations accumulation is less studied. We assessed factors associated with drug resistance mutations accumulation. We evaluated HIV chronically-infected patients from a clinic-based research cohort on first-line ART regimens with genotype results within 30 days of baseline. Methamphetamine use and ART adherence were self-reported at each study visit. High ART adherence was defined as 0-5% missed doses in the last 30 days. One-hundred twenty-five patients contributed 496 study visits. At baseline, 81% of patients reported high ART adherence; 90% reported no methamphetamine use in the prior 4 months, 8% used monthly or less and 2% used daily or weekly. Methamphetamine users and non-users had similarly high ART adherence (p=0.93). Adjusted incidence rate ratio (aIRR) of drug resistance mutations accumulation was 2.04 (95% CI 0.64, 6.46) for daily/weekly users and 1.71 (95% CI 0.66, 4.42) for patients with monthly or less users, compared to non-users. aIRR was 0.71 (95% CI 0.44, 1.15) with >5-10% missed ART doses and 1.21 (95% CI 0.80, 1.83) with >10% missed doses compared to 0-5% missed doses. We found no strong evidence for the effect of methamphetamine use and ART adherence on drug resistance mutations accumulation. Research cohort patients may have been more engaged in care and treatment adherent than non-cohort patients. Our findings suggest methamphetamine use might not lead to treatment failure among HIV patients who are otherwise engaged in care.
Sections du résumé
BACKGROUND
Antiretroviral therapy (ART) non-adherence and methamphetamine use are associated with higher HIV drug resistance prevalence. How they affect drug resistance mutations accumulation is less studied.
OBJECTIVE
We assessed factors associated with drug resistance mutations accumulation.
METHODS
We evaluated HIV chronically-infected patients from a clinic-based research cohort on first-line ART regimens with genotype results within 30 days of baseline. Methamphetamine use and ART adherence were self-reported at each study visit. High ART adherence was defined as 0-5% missed doses in the last 30 days.
RESULTS
One-hundred twenty-five patients contributed 496 study visits. At baseline, 81% of patients reported high ART adherence; 90% reported no methamphetamine use in the prior 4 months, 8% used monthly or less and 2% used daily or weekly. Methamphetamine users and non-users had similarly high ART adherence (p=0.93). Adjusted incidence rate ratio (aIRR) of drug resistance mutations accumulation was 2.04 (95% CI 0.64, 6.46) for daily/weekly users and 1.71 (95% CI 0.66, 4.42) for patients with monthly or less users, compared to non-users. aIRR was 0.71 (95% CI 0.44, 1.15) with >5-10% missed ART doses and 1.21 (95% CI 0.80, 1.83) with >10% missed doses compared to 0-5% missed doses.
CONCLUSION
We found no strong evidence for the effect of methamphetamine use and ART adherence on drug resistance mutations accumulation. Research cohort patients may have been more engaged in care and treatment adherent than non-cohort patients. Our findings suggest methamphetamine use might not lead to treatment failure among HIV patients who are otherwise engaged in care.
Identifiants
pubmed: 34176462
pii: CHR-EPUB-116329
doi: 10.2174/1570162X19666210625103902
pmc: PMC10659984
mid: NIHMS1940656
doi:
Substances chimiques
Anti-HIV Agents
0
Methamphetamine
44RAL3456C
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
497-503Subventions
Organisme : NIAID NIH HHS
ID : P30 AI027763
Pays : United States
Organisme : NIDA NIH HHS
ID : R01 DA017476
Pays : United States
Organisme : NIMH NIH HHS
ID : R01 MH096642
Pays : United States
Organisme : NIAID NIH HHS
ID : R24 AI067039
Pays : United States
Informations de copyright
Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.
Références
J Infect Dis. 2003 Dec 15;188(12):1820-6
pubmed: 14673760
AIDS Care. 2003 Dec;15(6):775-85
pubmed: 14617499
AIDS. 2006 Nov 14;20(17):2193-7
pubmed: 17086059
Drug Alcohol Depend. 2007 Sep 6;90(1):97-100
pubmed: 17428622
J Acquir Immune Defic Syndr. 2019 Jan 1;80(1):89-93
pubmed: 30272634
Open AIDS J. 2007;1:5-10
pubmed: 18923691
J Acquir Immune Defic Syndr. 2008 Apr 15;47(5):639-43
pubmed: 18285715
AIDS. 1999 Apr 16;13(6):F35-43
pubmed: 10397555
J Acquir Immune Defic Syndr. 2011 Feb 1;56(2):146-50
pubmed: 21116186
Am J Med. 2003 May;114(7):573-80
pubmed: 12753881
AIDS Behav. 2013 May;17(4):1478-87
pubmed: 23553345
AIDS Behav. 2018 Aug;22(8):2413-2425
pubmed: 29948340
AIDS Care. 2009 May;21(5):575-82
pubmed: 19444665
Am J Public Health. 2007 Jun;97(6):1067-75
pubmed: 17463384
JAMA. 2002 Jul 10;288(2):181-8
pubmed: 12095382
JMIR Public Health Surveill. 2020 Apr 13;6(2):e16847
pubmed: 32281937
AIDS Patient Care STDS. 2012 Jan;26(1):36-52
pubmed: 22070609
AIDS Behav. 2007 Mar;11(2):185-94
pubmed: 16897351
PLoS One. 2011;6(10):e25281
pubmed: 22046237
AIDS. 2007 Jan 11;21(2):239-41
pubmed: 17197817
AIDS Behav. 2020 Jun;24(6):1865-1875
pubmed: 31834542
Curr HIV/AIDS Rep. 2011 Dec;8(4):223-34
pubmed: 21858414
AIDS Care. 2012;24(12):1504-13
pubmed: 22530794