台湾南部 HIV 感染者中娱乐性药物使用的临床影响。

Clinical impact of recreational drug use among people living with HIV in southern Taiwan.

机构信息

Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

出版信息

J Microbiol Immunol Infect. 2021 Oct;54(5):952-962. doi: 10.1016/j.jmii.2020.07.016. Epub 2020 Aug 12.

DOI:10.1016/j.jmii.2020.07.016

PMID:32847749

Abstract

BACKGROUND

It is unclear about the impact of recreational drug use on the adherence, drug-drug interaction and the occurrence of sexual transmitted diseases (STDs) among people living with HIV.

MATERIAL AND METHODS

A retrospective study was conducted between Dec 2016, and July 2018 to assess the clinical impact of recreational drug consumption in people living with HIV with antiretroviral therapy. We collected data of the demographics, recreational drug use, laboratory results and STDs diagnoses. Potential drug-drug interactions were checked with reference databases. The association between recreational drug use and STDs, HIV viral load suppression and drug interactions were evaluated.

RESULTS

A total of 462 participants were enrolled, included 384 recreational drug users and 78 non-recreational drug users. Younger age (adjusted odds ratio [aOR], 0.94; 95% CI: 0.91-0.98; p = 0.001), longer HIV infection period (aOR, 1.11; 95% CI: 1.03-1.20; p = 0.009) and poor antiretroviral drug adherence (1-2 pills missing per month: aOR, 6.82; 95% CI: 3.50-13.27; p < 0.001; >2 pills missing per month: aOR, 3.50; 95% CI: 1.28-9.61; p = 0.015) were factors associated with recreational drug use. Methamphetamine and nitrites were two most common recreational drugs. Recreational drug use was significantly associated with STDs in one-year follow-up period (aOR, 2.43; 95% CI: 1.11-5.32; p = 0.027) but was not significantly associated with unsuppressed viral load, though a trend was observed (OR, 2.23; 95% CI: 0.92-5.37; p = 0.074). Potential interactions with recreational drugs included 33.1% antiretroviral drugs and 31.3% medications for comorbidities.

CONCLUSION

Recreational drug was associated with STDs. A great proportion of the patients consuming recreational drugs had potential interactions with antiretroviral drugs and medications for comorbidities. The association of recreational drug use and unsuppressed viral load warrants further investigation.

摘要

背景

目前尚不清楚娱乐性药物使用对接受抗逆转录病毒治疗的艾滋病毒感染者的依从性、药物相互作用和性传播疾病（性病）的发生有何影响。

材料和方法

本回顾性研究于 2016 年 12 月至 2018 年 7 月进行，旨在评估接受抗逆转录病毒治疗的艾滋病毒感染者中娱乐性药物使用的临床影响。我们收集了人口统计学、娱乐性药物使用、实验室结果和性病诊断的数据。参考数据库检查了潜在的药物相互作用。评估了娱乐性药物使用与性病、艾滋病毒病毒载量抑制和药物相互作用之间的关联。

结果

共纳入 462 名参与者，包括 384 名娱乐性药物使用者和 78 名非娱乐性药物使用者。年龄较小（调整后的优势比 [aOR]，0.94；95%CI：0.91-0.98；p=0.001）、艾滋病毒感染时间较长（aOR，1.11；95%CI：1.03-1.20；p=0.009）和抗逆转录病毒药物依从性差（每月漏服 1-2 片：aOR，6.82；95%CI：3.50-13.27；p<0.001；每月漏服>2 片：aOR，3.50；95%CI：1.28-9.61；p=0.015）是与娱乐性药物使用相关的因素。冰毒和亚硝酸酯是两种最常见的娱乐性药物。在一年的随访中，娱乐性药物使用与性病显著相关（aOR，2.43；95%CI：1.11-5.32；p=0.027），但与未抑制的病毒载量无显著相关性，尽管观察到一种趋势（OR，2.23；95%CI：0.92-5.37；p=0.074）。与娱乐性药物相关的潜在相互作用包括 33.1%的抗逆转录病毒药物和 31.3%的合并症治疗药物。