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Opioid substitution therapy reduces HIV-, drug-related mortality among individuals with HIV, drug addiction
Study findings presented at the 2015 International AIDS Society Conference show that individuals with HIV who inject drugs had lower HIV- and drug-related mortality after receiving opioid substitution treatment.
Bohdan Nosyk, PhD, of the British Columbia Centre for Excellence in HIV/AIDS in Vancouver, and colleagues analyzed population-level data for British Columbia from 1996 to 2010 to determine the independent and combined effects of opioid substitution treatment and highly active antiretroviral therapy (ART) on mortality among individuals with HIV who inject drugs (n = 1,727).
Bohdan Nosyk
During a median of 5.1 years of follow-up, 28.5% of the study cohort died; 18.7% due to drug-related caused and 55.8% due to HIV-related causes.
During opioid substitution treatment, standardized mortality ratios were 12.2 (95% CI, 9.8-15), compared with 30 (95% CI, 27.1-33.1) during periods without opioid substitution treatment.
Opioid substitution treatment (adjusted HR = 0.34; 95% CI, 0.23-0.49) and highly active ART (aHR = 0.39; 95% CI, 0.31-0.48) decreased risk for all-cause mortality, according to researchers. However, individuals had the lowest risk for death when treatments were used at the same time (aHR=0.16; 95% CI, 0.1-0.26).
Opioid substitution treatment and highly active ART independently protected against HIV-related death, drug-related death and death due to other causes, according to researchers.
“Our study adds to a growing body of evidence showing access to opioid agonist therapy has positive downstream effects on HIV-health related outcomes,” Nosyk said in a press release. “These findings strongly suggest opioid agonist therapy is an essential component to improving HIV outcomes among people who inject drugs [and] indicate integration of HIV care and addictions is a promising way to improve health care access among the vulnerable and hard-to-reach population of people who inject drugs. Further research is needed to determine how this can be implemented in a cost-effective way.” – by Amanda Oldt
Disclosure: Please see the full study for a list of all other authors’ relevant financial disclosures.