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 journalArticlepeer-review

    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
    DOIs
    StatePublished - Dec 1999

    Keywords

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

    ASJC Scopus subject areas

    • Health(social science)
    • Urban Studies
    • Public Health, Environmental and Occupational Health

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