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Detrimental
Effects of Continued Illicit Drug Use on the Treatment of HIV-1
Infection [Lucas,
GM, et al., JAIDS 2001;27:251]: This is a report from the
Moore Clinic at Johns Hopkins concerning a prospective study of
764 HIV-infected patients who participated in a standardized interview.
Results of this trial are summarized in the table below. Analysis
indicated that active drug users had both reduced access to HAART
and suboptimal response when this treatment was given.
| |
Active
drug use
n = 199 |
Former
drug use
n = 376 |
No
drug use
n = 189 |
| HAART |
56%* |
78% |
82% |
| Nonadherence
by history |
34%* |
17% |
1 |
Reduction
in VL (ART recipients),
log10
c/mL |
0.8%* |
1.6 |
1.7 |
Increase
in CD4 count
(ART recipients), median/mm3 |
65* |
122 |
116 |
| p
= < 0.05 for comparison with former users or with never users |
Comment: The results of this trial are possibly predictable,
but it sends an important message for all who are designing management
strategies for patients with HIV infection. The most encouraging component
of this report is the observation of good outcome among patients who
were reformed drug users, and this obviously needs a high priority.
Further, there may be some inherent danger in treating a population
that has high rates of nonadherence and virologic failure.
posted
8/14/2001
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