Methadone maintenance treatment has been associated with improved adherence to antiretroviral therapy (ART) for HIV-infected individuals with opioid use disorder. Researchers tracked a cohort of 297 HIV-infected individuals receiving methadone maintenance to investigate the dose-response relationship between methadone dose and ART adherence. The primary exposure was high-dose methadone (≥ 100 mg) and the primary outcome was optimal (≥ 95%) ART adherence. ART adherence rates were determined based on pharmacy refill data.
Patients receiving ≥ 100 mg/day of methadone had increased rates of optimal ART adherence (adjusted odd ratio [aOR], 1.38), compared with those receiving less.
When stratified by methadone dose, there was an association between increasing dose and the proportion of optimally adherent participants (aOR, 1.06 per 20 mg/day increase).
This study demonstrates a dose-response relationship between methadone dose and ART adherence among patients receiving methadone. To improve outcomes in the care of HIV-infected individuals with opioid use disorder, providers should ensure adequate and effective methadone dosing.
Jamie K. Lim, BSc† and Alexander Y. Walley, MD, MSc
† MD candidate, Boston University School of Medicine
Lappalainen L, Nolan S, Dobrer S, et al. Dose-response relationship between methadone dose and adherence to antiretroviral therapy among HIV-positive persons who use illicit opioids. Addiction. 2015;110(8):1330–1339.
Source: Alcohol, Other Drugs, and Health: Currrent Evidence – July/August 2015