Brown Medical School, The Miriam Hospital, 164 Summit Avenue, Providence, RI 02906, USA.
Curr Infect Dis Rep. 2008 Sep;10(5):432-8. doi: 10.1007/s11908-008-0068-x.
Although highly active antiretroviral therapy (HAART) has greatly reduced overall morbidity and mortality in patients with HIV, patients with substance use issues have been less likely than other patients with HIV to realize these benefits. Social obstacles (eg, lack of housing, minimal social support), and medical comorbidities (eg, mental illness, hepatitis), complicate the management of this group of patients. Not only are drug and alcohol users less likely to access medical care, initiation of HAART may be delayed due to concerns for adherence and the potential development of drug resistance. Ultimately, a multidisciplinary comprehensive approach is needed to both engage and retain this population in care. Through the integration of case management, addiction therapy, and medical treatment of HIV, we may be able to improve outcomes for patients with HIV and addiction.
尽管高效抗逆转录病毒疗法（HAART）大大降低了 HIV 患者的整体发病率和死亡率，但与其他 HIV 患者相比，有物质使用问题的患者不太可能从中受益。社会障碍（例如，缺乏住房、极少的社会支持）和医疗合并症（例如，精神疾病、肝炎）使这组患者的管理变得复杂。不仅是吸毒和酗酒者不太可能获得医疗保健，而且由于对依从性和潜在耐药性发展的担忧，HAART 的启动可能会延迟。最终，需要采用多学科综合方法来使这部分人群参与并维持治疗。通过整合病例管理、成瘾治疗和 HIV 治疗，我们也许能够改善 HIV 合并成瘾患者的预后。
