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首页> 外文期刊>AIDS Research and Human Retroviruses >Impact of use of alcohol and illicit drugs by AIDS patients on adherence to antiretroviral therapy in Bahia, Brazil
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Impact of use of alcohol and illicit drugs by AIDS patients on adherence to antiretroviral therapy in Bahia, Brazil

机译：艾滋病患者使用酒精和违禁药物对巴西巴伊亚州坚持抗逆转录病毒疗法的影响

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Use of alcohol and illicit drugs is a common finding among HIV-infected individuals, but there are many open questions about its impact on adherence to antiretroviral therapy and virological outcomes. Our study aimed to evaluate the impact of the use of alcohol and illicit drugs on the adherence to antiretroviral therapy (ART) among patients starting ART in Salvador, Brazil. We followed up 144 AIDS patients initiating ART for a 6-month period. At baseline, they were interviewed about demographics, behavior, and use of illicit drugs and alcohol. All of them had HIV-1 RNA plasma viral load and CD4 +/CD8+ cells count measured before starting therapy. After 60 days of treatment they were asked to answer a new questionnaire on adherence to ART. All patients were monitored during the following months, and new CD4+ cell count/HIV-1 RNA plasma viral load determinations were performed after 6 months of therapy. Optimal adherence to therapy was defined by self-reported questionnaire, by 95% use of prescribed drug doses, and by using plasma HIV-1 RNA viral load as a biological marker. A total of 61 (42.4%) patients reported alcohol use, 7 (4.9%) used illicit drugs, and 17 (11.8%) used both alcohol and illicit drugs. Being in a steady relationship was protective to nonadherence (95% CI: 0.18-0.84). Missing more than two medical visits was also associated with a 68% higher likelihood of nonadherence (95% CI: 0.10-1.02). After logistic regression we detected a higher risk of nonadherence for patients declaring use of alcohol plus illicit drugs (odds ratio=6.0; 95% CI: 1.78-20.28) or high-intensity use of alcohol (odds ratio=3.29; 95% CI: 1.83-5.92). AIDS patients using alcohol and/or illicit drugs are socially vulnerable, and need specific and flexible programs, combining mental health care, harm reduction strategies, and assisted drug therapy to maximize the chances of successful use of ART.
机译：酒精和非法药物的使用是感染HIV的个体的常见发现，但是关于其对坚持抗逆转录病毒疗法和病毒学结果的影响，存在许多悬而未决的问题。我们的研究旨在评估在巴西萨尔瓦多开始接受抗逆转录病毒疗法（ART）的患者中使用酒精和非法药物的影响。我们随访了144名AIDS患者，在6个月内发起了ART。在基线时，他们接受了有关人口统计，行为以及非法药物和酒精使用的采访。所有患者在开始治疗前均具有HIV-1 RNA血浆病毒载量和CD4 + / CD8 +细胞计数。治疗60天后，要求他们回答有关抗逆转录病毒疗法依从性的新问卷。在接下来的几个月中对所有患者进行了监测，治疗6个月后进行了新的CD4 +细胞计数/ HIV-1 RNA血浆病毒载量测定。通过自我报告的问卷，95％使用处方药剂量以及使用血浆HIV-1 RNA病毒载量作为生物学指标来定义对治疗的最佳依从性。共有61位（42.4％）患者报告了饮酒，其中7位（4.9％）使用了非法药物，而17位（11.8％）同时使用了酒精和非法药物。保持稳定的关系可以防止不依从（95％CI：0.18-0.84）。错过两次以上的医疗就诊也可能导致不依从的可能性增加68％（95％CI：0.10-1.02）。在逻辑回归后，我们发现宣布使用酒精加非法药物（比值= 6.0; 95％CI：1.78-20.28）或高强度使用酒精（比值= 3.29; 95％CI ：）的患者出现不依从的风险更高。 1.83-5.92）。使用酒精和/或非法药物的艾滋病患者在社会上很脆弱，需要有针对性和灵活的计划，将精神保健，减少伤害的策略和辅助药物治疗相结合，以最大程度地成功使用抗逆转录病毒疗法。

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