HAART and Drug Treatment May Improve Survival in People With HIV Who Inject Drugs
Highly active antiretroviral therapy (HAART) and methadone treatment have led to significant improvements in survival for people with HIV and opioid dependence, respectively. It is not clear, however, whether HIV infection and HAART influence the length of survival among people with injection drug use (IDU) who receive drug treatment.
This observational study from Spain examined survival among 1181 people with IDU (59% with HIV) who had been admitted to a substance abuse treatment program before or after 1997 (the era of established methadone programs and HAART). One-third of subjects with HIV had received HAART.
- Survival was shortest in people with IDU and HIV admitted to drug treatment before 1997.
- However, survival has improved substantially since 1997, when HAART was introduced.
- Survival since 1997 in people with IDU and HIV was similar to that in people with IDU but not HIV.
This study supports the benefit of both HAART and drug treatment on survival in people with IDU and HIV. The longer survival in patients who did not receive HAART may be partially attributable to access to drug treatment, prophylaxis for opportunistic infections, and ongoing clinical care. The increase in survival, even in patients with HIV who did not receive HAART, is encouraging. Yet, it reminds us of the challenge in providing state-of-the-art care to patients with substance use disorders and HIV.David A. Fiellin, MD
Muga R, Langohr K, Tor J, et al. Survival of HIV-infected injection drug users (IDUs) in the highly active antiretroviral therapy era, relative to sex- and age-specific survival of HIV-uninfected IDUs. CID. 2007;45(3):370–376.