Continued Substance Use Among People Living With HIV–Hepatitis-C Co-Infection and Receiving Antiretroviral Therapy

Abstract

Background Co-infection with HIV and Hepatitis-C virus (HCV) poses a significant threat to personal and public health. Substance use among co-infected persons leads to increased morbidity and mortality. The purpose of this study is to examine the continued substance use of people living with HIV-HCV co-infection and receiving antiretroviral therapy (ART). Methods Individuals living with HIV infection in Atlanta, GA and currently receiving ART (N = 678) completed audio-computer assisted self-interviews for demographic, health, and behavior characteristics; unannounced pill counts to assess ART adherence over one-month; finger-stick blood specimens collected for HCV antibody testing and urine specimens for drug use screening; and obtained HIV viral load and CD4 cell counts from their medical provider. We performed cross-sectional analyses of behavioral and biological markers of health, health behaviors, and substance use. Results Among participants 131 (19%) were HIV-HCV co-infected; 53% of HIV-mono-infected and 60% of HIV-HCV co-infected participants tested positive for use of at least one non-alcohol drug; THC and cocaine were most prevalent. HIV-HCV co-infected individuals were older, with no other significant differences. Within the HIV-HCV co-infected participants, drug users (N = 87) did not differ from non-drug users (N= 53) in terms of ART adherence. However, drug users were significantly more likely to have uncontrolled HIV (17%) compared to those who did not test drug positive (4%). Conclusions Substance use is prevalent in persons with HIV-HCV co-infection and may interfere with ART. Research with a larger more representative sample is needed to replicate and confirm these results.

Opioid-Related Diagnoses and Concurrent Claims for HIV, HBV, or HCV among Medicare Beneficiaries, United States, 2015

“…Our results extend previous studies and confirm that ORCs are strongly associated with the 6 categories of infection (i.e., HIV [32], acute or chronic HBV [33], and acute or chronic HCV [13]) [34,35]. Beneficiaries with claims for opioid-related diagnoses and acute HBV or acute or chronic HCV infection were 1–2 times as likely to have opioid overdose claims, compared with beneficiaries without these claims.…”

A Mechanistic and Pathophysiological Approach for Stroke Associated with Drugs of Abuse

“…In order to evaluate the net effect of cocaine abuse on stroke risk, co-triggers, predictors, and co-morbidities of stroke (and other vascular diseases) should be taken into account [62]. Factors such as infections with human immunodeficiency virus type 1 (HIV-1) and hepatitis C virus (HCV) are of great importance [63,64]. So far, studies have supported the fact that cocaine use is prevalent in individuals infected with HIV and/or HCV, and vice versa [63,64,65].…”

“…Factors such as infections with human immunodeficiency virus type 1 (HIV-1) and hepatitis C virus (HCV) are of great importance [63,64]. So far, studies have supported the fact that cocaine use is prevalent in individuals infected with HIV and/or HCV, and vice versa [63,64,65]. Moreover, a few clinical studies suggested that cocaine abuse may increase HIV-1 viral load, and thus increase acquired immune deficiency syndrome (AIDS)-related mortality, even among patients under antiretroviral therapy (ART) [65].…”

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“…Experts from across Switzerland collaborated to develop a national strategy for the elimination of hepatitis by 2030 [16]. These efforts have initiated an increase in research, analyses and forecasts, which require updates to our original modeling efforts.…”