Evaluating supervised HAART in late-stage HIV among drug users

A preliminary report

Barbara Greenberg, Alan Berkman, Rogel Thomas, David Hoos, Ruth Finkelstein, Jacquie Aste, David Vlahov

Research output: Contribution to journalArticle

Abstract

Objective. To examine response to highly active antiretroviral therapy (HAART) among a sample of treatment-experienced patients in the late stage of human immunodeficiency virus (HIV) infection in residential health care facilities (RHCFs) in New York City facilities designated for HIV/AIDS (acquired immunodeficiency syndrome) when access and adherence are maximized. Methods. Medical record review of 111 patients. Results. Demographics were mean age 42 years; 58% male; 60% African-American; 31% Hispanic; 57% injection drug users (IDUs); 23% with history of dementia; 52% hepatitis C virus (HCV) antibody seropositive; 80% on HAART, of whom 18% had lipodystrophy. Of 88 patients on HAART, 52% had a decreased viral load (> 1/2 log) versus 13% of 23 not on HAART (P <.05); a > 1/2 log viral load increase was seen in 8% and 35%, respectively (P <.05). Those with viral load increase were more likely than those with stable/decreased viral load to be IDUs (71% vs. 64%) and to have HCV seropositivity (86% vs. 53%), even with similar initial CD4 + cell count, viral load, and follow-up time. Conclusion. In a predominantly minority IDU population who are treatment experienced, 50% of the patients successfully responded to treatment with supervised therapy. The RHCFs in New York City provide a unique opportunity to examine further factors associated with response to HAART in an environment in which medication administration and adherence are maximized and monitored carefully.

Original languageEnglish (US)
Pages (from-to)468-480
Number of pages13
JournalJournal of Urban Health
Volume76
Issue number4
StatePublished - Dec 1999
Externally publishedYes

Fingerprint

Highly Active Antiretroviral Therapy
Drug Users
Viral Load
HIV
drug
Health Facilities
Injections
Acquired Immunodeficiency Syndrome
Delivery of Health Care
Lipodystrophy
contagious disease
Hepatitis C Antibodies
Medication Adherence
Virus Diseases
Therapeutics
CD4 Lymphocyte Count
health care
Hispanic Americans
Hepacivirus
African Americans

Keywords

  • Advanced HIV
  • HAART
  • Hepatitis C seropositivity
  • IDUs
  • Residential health care facilities
  • Substance abuse
  • Viral load

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Greenberg, B., Berkman, A., Thomas, R., Hoos, D., Finkelstein, R., Aste, J., & Vlahov, D. (1999). Evaluating supervised HAART in late-stage HIV among drug users: A preliminary report. Journal of Urban Health, 76(4), 468-480.

Evaluating supervised HAART in late-stage HIV among drug users : A preliminary report. / Greenberg, Barbara; Berkman, Alan; Thomas, Rogel; Hoos, David; Finkelstein, Ruth; Aste, Jacquie; Vlahov, David.

In: Journal of Urban Health, Vol. 76, No. 4, 12.1999, p. 468-480.

Research output: Contribution to journalArticle

Greenberg, B, Berkman, A, Thomas, R, Hoos, D, Finkelstein, R, Aste, J & Vlahov, D 1999, 'Evaluating supervised HAART in late-stage HIV among drug users: A preliminary report', Journal of Urban Health, vol. 76, no. 4, pp. 468-480.
Greenberg B, Berkman A, Thomas R, Hoos D, Finkelstein R, Aste J et al. Evaluating supervised HAART in late-stage HIV among drug users: A preliminary report. Journal of Urban Health. 1999 Dec;76(4):468-480.
Greenberg, Barbara ; Berkman, Alan ; Thomas, Rogel ; Hoos, David ; Finkelstein, Ruth ; Aste, Jacquie ; Vlahov, David. / Evaluating supervised HAART in late-stage HIV among drug users : A preliminary report. In: Journal of Urban Health. 1999 ; Vol. 76, No. 4. pp. 468-480.
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