HIV-Infected Patients Receiving Methadone are More Likely to Adhere to Antiretroviral Treatment when Provided Higher Methadone Doses

Methadone maintenance treatment has been associated with improved adherence to antiretroviral therapy (ART) for HIV-infected individuals with opioid use disorder. Researchers tracked a cohort of 297 HIV-infected individuals receiving methadone maintenance to investigate the dose-response relationship between methadone dose and ART adherence. The primary exposure was high-dose methadone (≥ 100 mg) and the primary outcome was optimal (≥ 95%) ART adherence. ART adherence rates were determined based on pharmacy refill data.

• Patients receiving ≥ 100 mg/day of methadone had increased rates of optimal ART adherence (adjusted odd ratio [aOR], 1.38), compared with those receiving less.
• When stratified by methadone dose, there was an association between increasing dose and the proportion of optimally adherent participants (aOR, 1.06 per 20 mg/day increase).

Comments:

This study demonstrates a dose-response relationship between methadone dose and ART adherence among patients receiving methadone. To improve outcomes in the care of HIV-infected individuals with opioid use disorder, providers should ensure adequate and effective methadone dosing.

Jamie K. Lim, BSc† and Alexander Y. Walley, MD, MSc

Reference:

Lappalainen L, Nolan S, Dobrer S, et al. Dose-response relationship between methadone dose and adherence to antiretroviral therapy among HIV-positive persons who use illicit opioids. Addiction. 2015;110(8):1330–1339.