| Titre : | Modified directly observed therapy (MDOT) for injection drug users with HIV disease |
| Titre traduit : | (Traitement antiviral et de maintenance à la méthadone, modifié et supervisé, pour des usagers de drogues injectables infectés par le VIH.) |
| Auteurs : | E. F. McCANCE-KATZ ; M. N. GOUREVITCH ; J. H. ARNSTEN ; SARLO J. ; RAINEY P. ; JATLOW P. |
| Type de document : | Périodique |
| Année de publication : | 2002 |
| Format : | 271-278 / graph. ; tabl. |
| Note générale : |
American Journal on Addictions, 2002, 11, (4), 271-278 |
| Langues: | Anglais |
| Discipline : | TRA (Traitement et prise en charge / Treatment and care) |
| Mots-clés : |
Thésaurus mots-clés TRAITEMENT DE MAINTENANCE ; ANTIRETROVIRAUX ; METHADONE ; VIH ; OBSERVANCE DU TRAITEMENT ; EFFICACITE |
| Résumé : |
ENGLISH : Injection drug use is an important factor in the spread of HIV infection, and strategies to enhance adherence to HIV therapeutics are critically important to controlling viral transmission and improving clinical outcomes. To this end, the authors sought (1) to enhance adherence to highly active antiretroviral therapy (HAART) among methadone-maintained injection drug users (IDUs) using modified directly observed therapy (MDOT) and (2) to define interactions between methadone and HAART and the potential contribution of drug interactions to adherence and HIV out comes in this population. Adherence was explored here through a pilot, unblinded, 24-week study in a methadone maintenance program in which Simplified HAART (efavirenz and didanosine [once daily] and a second nucleoside [twice daily] was administered 6 days/week by clinic staff to HIV-infected IDUs (n=5) with their methadone. Evening doses of riboflavin-tagged nucleoside and one full day of medication weekly were given as lake home doses. As a result of HAART administration, four of five participants with mean viral load at baseline of 10(5) copies/ml had undetectable viral load by 8 weeks of treatment (p=.043). Methadone area under the curve (AUC) decreased by 55% (p=.007) within 2 weeks of initiating this HAART regimen, and a mean methadone dose increase of 52% was required. The autors conclude that MDOT is a promising intervention for the treatment of IDUs with HIV disease, though significant drug interactions must be monitored for carefully and rapidly addressed. (Author' s abstract) |
| Note de contenu : | graph. ; tabl. |
| Domaine : | Drogues illicites / Illicit drugs |
| Refs biblio. : | 19 |
| Affiliation : |
Medical College of Virginia, 1200 East Broad St., Room 1142, West Hospital, 11th floor, South wing, Richmond, VA 23298-0109. Email : emccancekatzmail1.vcu.edu Etats-Unis. United States. |
| Numéro Toxibase : | 206506 |
| Centre Emetteur : | 02 Coordonnateur |
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