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Impact of Opioid Substitution Therapy on Antiretroviral Therapy Outcomes: A Systematic Review and Meta-Analysis

View Article: PubMed Central - PubMed

ABSTRACT

This meta-analysis provides strong evidence that opioid substitution therapy improves several key outcomes of the HIV care continuum among people who inject drugs, including recruitment onto antiretroviral therapy, retention in care, adherence, and viral suppression.

No MeSH data available.


Related in: MedlinePlus

Forest plot of the effect of opioid substitution therapy on plasma viral suppression among people who inject drugs (PWID) on antiretroviral therapy (ART), defined as the proportion of those on ART with undetectable plasma human immunodeficiency virus (HIV) RNA loads, based on the threshold of detection in each study (<500, <400 or <50 copies/mL). I2 and P value are measures of between-study heterogeneity. Note that Roux used multiple thresholds depending on clinical site. Abbreviations: CI, confidence interval; N, total sample size of PWID; OR, odds ratio; threshold, number of HIV-1 RNA copies/mL used as threshold for HIV-1 RNA detection in that study.
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CIW416F3: Forest plot of the effect of opioid substitution therapy on plasma viral suppression among people who inject drugs (PWID) on antiretroviral therapy (ART), defined as the proportion of those on ART with undetectable plasma human immunodeficiency virus (HIV) RNA loads, based on the threshold of detection in each study (<500, <400 or <50 copies/mL). I2 and P value are measures of between-study heterogeneity. Note that Roux used multiple thresholds depending on clinical site. Abbreviations: CI, confidence interval; N, total sample size of PWID; OR, odds ratio; threshold, number of HIV-1 RNA copies/mL used as threshold for HIV-1 RNA detection in that study.

Mentions: Ten studies were included that described the impact of OST on viral suppression (detection threshold being 500, 400, or 50 copies/mL; Figure 3; Supplementary Table 4). Three studies were excluded due to presenting time to viral suppression, where an OR could not be calculated, 1 for presenting the impact on viral loads as a continuous outcome, 3 for being duplicate cohorts, and 1 for presenting the number of visits with suppressed viral loads. The use of OST was associated with a 45% increase in the odds of viral suppression (OR, 1.45; 95% CI, 1.21–1.73; P < .001). The results were fairly homogeneous (I2 = 22%; P = .24).Figure 3.


Impact of Opioid Substitution Therapy on Antiretroviral Therapy Outcomes: A Systematic Review and Meta-Analysis
Forest plot of the effect of opioid substitution therapy on plasma viral suppression among people who inject drugs (PWID) on antiretroviral therapy (ART), defined as the proportion of those on ART with undetectable plasma human immunodeficiency virus (HIV) RNA loads, based on the threshold of detection in each study (<500, <400 or <50 copies/mL). I2 and P value are measures of between-study heterogeneity. Note that Roux used multiple thresholds depending on clinical site. Abbreviations: CI, confidence interval; N, total sample size of PWID; OR, odds ratio; threshold, number of HIV-1 RNA copies/mL used as threshold for HIV-1 RNA detection in that study.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC5036913&req=5

CIW416F3: Forest plot of the effect of opioid substitution therapy on plasma viral suppression among people who inject drugs (PWID) on antiretroviral therapy (ART), defined as the proportion of those on ART with undetectable plasma human immunodeficiency virus (HIV) RNA loads, based on the threshold of detection in each study (<500, <400 or <50 copies/mL). I2 and P value are measures of between-study heterogeneity. Note that Roux used multiple thresholds depending on clinical site. Abbreviations: CI, confidence interval; N, total sample size of PWID; OR, odds ratio; threshold, number of HIV-1 RNA copies/mL used as threshold for HIV-1 RNA detection in that study.
Mentions: Ten studies were included that described the impact of OST on viral suppression (detection threshold being 500, 400, or 50 copies/mL; Figure 3; Supplementary Table 4). Three studies were excluded due to presenting time to viral suppression, where an OR could not be calculated, 1 for presenting the impact on viral loads as a continuous outcome, 3 for being duplicate cohorts, and 1 for presenting the number of visits with suppressed viral loads. The use of OST was associated with a 45% increase in the odds of viral suppression (OR, 1.45; 95% CI, 1.21–1.73; P < .001). The results were fairly homogeneous (I2 = 22%; P = .24).Figure 3.

View Article: PubMed Central - PubMed

ABSTRACT

This meta-analysis provides strong evidence that opioid substitution therapy improves several key outcomes of the HIV care continuum among people who inject drugs, including recruitment onto antiretroviral therapy, retention in care, adherence, and viral suppression.

No MeSH data available.


Related in: MedlinePlus