Illicit Drug Use and HIV Treatment Outcomes in a U.S. Cohort

The goal of the current study was to assess the prevalence of illicit drug use and the impact of HIV treatment using multivariable regression of cross-sectional data from participants in the Study of Fat Redistribution and Metabolic Change in HIV Infection.

In 1,163 participants with HIV and 294 controls, the researchers analyzed the prevalence of specific illicit drug use (ever, current), being on HAART among those with an indication, and current HIV RNA and CD4 cell count among HAART users.

Approximately 50 percent of participants were non-Caucasian and 33 percent were women; median age was 42. Eighty-six percent of HIV-infected and 67 percent of controls reported ever using illicit drugs (P<0.0001); 28 percent of HIV-infected and 16 percent of controls reported current use (P=0.0001). Adjusted models showed that current cocaine use and past heroin use were associated with not currently being on HAART. Among HAART users, those reporting past heroin use were as likely to have an undetectable HIV viral load as those who had never used heroin. Current and past cocaine use and current heroin use was associated with lower odds of undetectable HIV RNA. Previous amphetamine use was associated with having an undetectable HIV load. CD4 lymphocyte counts showed similar results.

"Illicit drug use in the US is common, although far fewer report current use than past use. Among HIV-infected patients, understanding the type of illicit drug used and whether drug use was in the past or ongoing is important because of their differential effects on treatment outcomes," the researchers concluded.

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