Association between recent methamphetamine use, antiretroviral therapy and HIV viral load; a mediation analysis from a cohort of HIV positive persons who inject drugs in Hai Phong, Vietnam - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue International Journal of STD and AIDS Année : 2023

Association between recent methamphetamine use, antiretroviral therapy and HIV viral load; a mediation analysis from a cohort of HIV positive persons who inject drugs in Hai Phong, Vietnam

Jonathan Feelemyer
Don Des Jarlais
  • Fonction : Auteur
Huong Duong Thi
Oanh Khuat Thi Hai
  • Fonction : Auteur
Khuê Pham Minh
  • Fonction : Auteur
Giang Hoang Thi
  • Fonction : Auteur
Thanh Nham Thi Tuyet
  • Fonction : Auteur
Charles Cleland
  • Fonction : Auteur
Kamyar Arasteh
  • Fonction : Auteur
Ellen Caniglia
  • Fonction : Auteur
Yu Chen
  • Fonction : Auteur
Gavin Bart
  • Fonction : Auteur
Vinh Vu Hai
  • Fonction : Auteur
Mai Le Sao
  • Fonction : Auteur
Maria Khan
  • Fonction : Auteur

Résumé

Background There has been a significant increase in methamphetamine use among persons who use drugs in Vietnam in the last 5–10 years. We examined the degree to which adherence to antiretroviral therapy (ART) mediates the relationship between recent methamphetamine use and unsuppressed HIV viral load among people who inject drugs (PWID) in Hai Phong, Vietnam. Methods We recruited PWID from October 2016-October 2018 and enrolled HIV positive PWID into a cohort, with up to three years of total follow-up. We assessed relationships among recent methamphetamine use frequency, ART adherence and unsuppressed HIV viral load. Mediation analysis was used to estimate the total and natural direct effects of recent methamphetamine use on unsuppressed HIV viral load and the indirect effect proportion. Results We enrolled 792 HIV seropositive PWID into the cohort; approximately 75.9% reported high/perfect ART adherence at baseline and 81.3% were virally suppressed. In mediation analysis, the total effect for the association between methamphetamine use and unsuppressed HIV viral load (1000 copies/mL) was 3.94 (95% CI: 1.95, 7.96); the natural direct effect was 2.14 (95% CI: 1.29, 3.55); the proportion mediated by self-reported ART adherence was 0.444. Similar results were found when examining lower unsuppressed HIV viral load cutpoints of 250 copies/mL and 500 copies/mL. Conclusions Methamphetamine use is associated with unsuppressed HIV viral load among PWID despite high levels of ART adherence. Further research is needed to better understand these relationships, with emphasis on potential biological pathways that may interact with ART.

Domaines

Immunologie

Dates et versions

hal-03942331 , version 1 (17-01-2023)

Identifiants

Citer

Jonathan Feelemyer, Don Des Jarlais, Nicolas Nagot, Huong Duong Thi, Oanh Khuat Thi Hai, et al.. Association between recent methamphetamine use, antiretroviral therapy and HIV viral load; a mediation analysis from a cohort of HIV positive persons who inject drugs in Hai Phong, Vietnam. International Journal of STD and AIDS, 2023, 34 (4), pp.236-244. ⟨10.1177/09564624221142366⟩. ⟨hal-03942331⟩
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