HIV And HCV infection among opiate-dependent patients and methadone doses: the PROTEUS study

ABSTRACT

Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) are prevalent infections in opiate-dependent patients. Opiate replacement treatment (ORT) with methadone or buprenorphine is associated with several important outcomes among patients with opiate dependence. However, little is known about outcomes in patients with HIV and/or HCV infections that are in ORT. Also, it is not well established whether the presence of HCV or HIV infection could be associated with higher methadone doses. This paper reanalyzes the database of PROTEUS study, using two principal variables: methadone dose and presence of HIV and/or HCV infection. PROTEUS recruited 621 patients (84.1% were male, mean age: 38.9 years, SD: 7.9), information about the presence of HIV in status was available for 390 patients. Of those, 134 (34.4%) were HIV-infected. Whilst, information about HCV infection was available for 377 patients. Of those, 315 (83.6%) were HCV-infected. Information on HIV/HCV coinfection was available for 376 patients, of those, 112 (29.8%) had this coinfection. HIV-infected and HIV/HCV-coinfected patients received higher methadone doses than those without these infections. Antiretroviral therapy (ART) was used in 80% of patients with HIV infection. The proportion of patients taking antiretroviral drugs was significantly higher for patients treated with higher methadone doses (p < 0.01). Findings suggest that HIV-infected and HIV/HVC-coinfected patients in ORT require higher methadone dose.

KEYWORDS:

• HIV
• HCV
• opiate-dependent patients
• opiate replacement treatment
• methadone

Acknowledgement

The authors thank to the PROTEUS investigators, contributors and patients for their participation in the study.

Disclosure statement

Carlos Roncero has received fees to give talks for Janssen-Cilag, Bristol-Mayers Squibb, Ferrer-Brainfarma, Pfizer,Reckitt-Benckiser/Indivior, Lundbeck, Otsuka, Servier, Lilly, Shire, GSK, and Astra. He has received financial compensation forhis participation as a member of the Janssen-Cilag, Lilly, and Shire board. He has carried out the PROTEUS project, whichwas funded by a grant from Reckitt-Benckisert. The author has no other relevant affiliations or financial volvement with anyorganization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in themanuscript apart from those disclosed. Daniel Fuster reports no conflicts of interest. Raul Felipe Palma-Alvarez has received afee to give talks for Mundipharma. Laia Rodriguez-Cintas declares no conflicts of interest. Nieves Martinez-Luna JavierÁlvarez has received grants and served as consultant or advisor during the last four years for the following entities: Reckitt-Benckiser, Indivior, Shire.

ORCID

Carlos Roncero http://orcid.org/0000-0003-1421-7385

Raul Felipe Palma-Álvarez http://orcid.org/0000-0002-6428-9865

Nieves Martinez-Luna http://orcid.org/0000-0001-8473-0606

F. Javier Álvarez http://orcid.org/0000-0002-7566-5678

Additional information

Funding

PROTEUS project was supported by a Reckitt-Benckiser/Indivior grant. Reckitt-Benckiser had no role in the study design, data compilation, analysis or interpretation of the information, writing the manuscript, or the decision to submit the paper for publication. Dr Alvarez participation in the study was provided by grants from the the Instituto de Salud Carlos III, Redes Temáticas de Investigación Cooperativa, Red de Trastornos Adictivos RD12/0028/0012 & RD16/0017/0006, co-funded by FEDER funds of the European Union–a way to build Europe.