Titre : | Treatment of medical, psychiatric, and substance-use comorbidities in people infected with HIV who use drugs. HIV in people who use drugs 4 (2010) |
Auteurs : | F. L. ALTICE ; A. KAMARULZAMAN ; V. SORIANO ; M. T. SCHECHTER ; G. H. FRIEDLAND |
Type de document : | Article : Périodique |
Dans : | Lancet (The) (Vol.376, n°9738, Jul 31, 2010) |
Article en page(s) : | 367-387 |
Langues: | Anglais |
Discipline : | MAL (Maladies infectieuses / Infectious diseases) |
Mots-clés : |
Thésaurus mots-clés COMORBIDITE ; VIH ; TRAITEMENT ; INFECTION ; TUBERCULOSE ; ALCOOL ; OPIOIDES ; DEPENDANCE ; HEPATITE ; PRODUIT DE SUBSTITUTION |
Résumé : | HIV-infected drug users have increased age-matched morbidity and mortality compared with HIV-infected people who do not use drugs. Substance-use disorders negatively affect the health of HIV-infected drug users, who also have frequent medical and psychiatric comorbidities that complicate HIV treatment and prevention. Evidence-based treatments are available for the management of substance-use disorders, mental illness, HIV and other infectious complications such as viral hepatitis and tuberculosis, and many non-HIV-associated comorbidities. Tuberculosis co-infection in HIV-infected drug users, including disease caused by drug-resistant strains, is acquired and transmitted as a consequence of inadequate prescription of antiretroviral therapy, poor adherence, and repeated interfaces with congregate settings such as prisons. Medication-assisted therapies provide the strongest evidence for HIV treatment and prevention efforts, yet are often not available where they are needed most. Antiretroviral therapy, when prescribed and adherence is at an optimum, improves health-related outcomes for HIV infection and many of its comorbidities, including tuberculosis, viral hepatitis, and renal and cardiovascular disease. Simultaneous clinical management of multiple comorbidities in HIV-infected drug users might result in complex pharmacokinetic drug interactions that must be adequately addressed. Moreover, interventions to improve adherence to treatment, including integration of health services delivery, are needed. Multifaceted, interdisciplinary approaches are urgently needed to achieve parity in health outcomes in HIV-infected drug users. [Author's abstract] |
Domaine : | Plusieurs produits / Several products |
Sous-type de document : | Revue de la littérature / Literature review |
Refs biblio. : | 166 |
Affiliation : | Department of Medicine, Section of Infectious Diseases, Yale University, New Haven, CT, USA; Centre of Excellence in Research in AIDS, University of Malaya, Kuala Lumpur, Malaysia / Malaisie |
Lien : | http://www.thelancet.com/series/hiv-in-people-who-use-drugs |
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