Association between substance use disorders and sustained viral suppression: a longitudinal analysis among people with HIV in South Carolina.

IF 3.4 2区医学 Q3 IMMUNOLOGY

AIDS Pub Date : 2024-11-28 DOI:10.1097/QAD.0000000000004077

Buwei He, Shujie Chen, Xueying Yang, Bankole Olatosi, Sharon Weissman, Xiaoming Li, Jiajia Zhang

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引用次数: 0

Abstract

Objectives: Substance use disorders (SUDs) are a significant public health concern across the United States and may pose a risk to achieving sustained viral suppression (SVS) in people with HIV (PWH). This study aims to examine the association between SUDs and SVS among PWH.

Design: Using electronic health records from the South Carolina Department of Health, we conducted a retrospective study of adults diagnosed with HIV between January 2006 and December 2019.

Methods: The impact of SUDs on SVS was assessed using generalized linear mixed model. Potential confounders included age, sex, chronic diseases history, etc. Stepwise selection was performed to decide the confounders included in the final model, and the optimal correlation structure was determined by Akaike information criterion.

Results: Of the 9412 eligible participants, 7481 (79.48%) had reached SVS status during their follow-up periods. SUDs related to alcohol (adjusted odds ratio (AOR) = 1.70, 95% confidence interval (CI): 1.46-1.98), cannabis (AOR = 1.62, 95% CI: 1.35-1.95), cocaine (AOR = 1.95, 95% CI: 1.60-2.37), opioid (AOR = 1.91, 95% CI: 1.13-3.23), and tobacco (AOR = 1.80, 95% CI: 1.69-1.92) were negatively associated with SVS. Individuals with chronic conditions such as cardiovascular disease (AOR=0.31, 95% CI: 0.29-0.33), diabetes (AOR=0.49, 95% CI: 0.41-0.59), and cancer (AOR=0.47, 95% CI: 0.38-0.58) showed a higher likelihood of maintaining SVS.

Conclusion: This large cohort study of PWH with extended follow-up highlights the negative impact of SUDs on maintaining SVS. Long-term strategies for reducing substance use could support SVS in HIV patients.

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物质使用障碍与持续病毒抑制之间的关系：南卡罗来纳州艾滋病毒感染者的纵向分析。

目的：物质使用障碍（sud）在美国是一个重要的公共卫生问题，可能对HIV感染者（PWH）实现持续病毒抑制（SVS）构成风险。本研究旨在探讨PWH患者的sud与SVS之间的关系。设计：使用南卡罗来纳州卫生部的电子健康记录，我们对2006年1月至2019年12月期间被诊断患有艾滋病毒的成年人进行了回顾性研究。方法：采用广义线性混合模型评价sud对SVS的影响。潜在的混杂因素包括年龄、性别、慢性病史等。通过逐步选择确定最终模型中包含的混杂因素，并根据赤池信息准则确定最优的相关结构。结果：9412名符合条件的参与者中，7481名（79.48%）在随访期间达到SVS状态。与酒精(调整优势比（AOR) = 1.70, 95%可信区间（CI）： 1.46-1.98）、大麻（AOR = 1.62, 95% CI: 1.35-1.95）、可卡因（AOR = 1.95, 95% CI: 1.60-2.37）、阿片类药物（AOR = 1.91, 95% CI: 1.13-3.23）和烟草（AOR = 1.80, 95% CI: 1.69-1.92）相关的SUDs与SVS呈负相关。患有慢性疾病的个体，如心血管疾病（AOR=0.31, 95% CI: 0.29-0.33）、糖尿病（AOR=0.49, 95% CI: 0.41-0.59）和癌症（AOR=0.47, 95% CI: 0.38-0.58），维持SVS的可能性更高。结论：这项关于PWH的大型队列研究和长期随访强调了SUDs对维持SVS的负面影响。减少药物使用的长期战略可以支持艾滋病毒患者的SVS。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

AIDS 医学-病毒学

CiteScore

5.90

自引率

5.30%

发文量

478

审稿时长

3 months

期刊介绍： Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.