ABSTRACT
Objective To explore the efficacy and safety of a raltegravir (RAL)-containing regimen among patients on methadone maintenance therapy.Methods From January 2010 to November 2010, 30 virus (HIV) treatment naive patients who were on methadone maintenance therapy were enrolled from a HIV clinic in Kunming, Yunnan Province and a HIV clinic in Hengyang, Hunan Province.All patients were given RAL, tenofovir (TDF) and lamivudine (3TC) as highly active antiretroviral therapy (HARRT).Patients were followed up for 48 weeks to evaluate the adjustment of methadone dose, opiate withdrawal reaction, antiretroviral efficacy and safety.Results From January 2010 to November 2010, 30 HIV patients were enrolled from the two appointed HIV clinics.The mean age was 39±6 years, with 73.3% male patients and 97% Han population.Before the treatment, their mean CD4+T lymphocyte counts was 210 /μL.Ninety percent of patients were co-infected with hepatitis C.Twenty-nine patients who completed study follow-up were included in final analysis.Five (17.8%) patients reported opiate withdrawal symptoms and increased methadone dose 4 weeks after HARRT.At 24 weeks and 48 weeks of HARRT, the average increase of CD4+T lymphocyte counts were (136±71) /μL and (185±88)/μL, respectively.Among patients who provided valid HIV-1 RNA testing results, 82.6% (19/23) and 95.8% (23/24) of patients had undetectable viral load at week 24 and week 48.Six grade 1-2 adverse events were reported in 4 patients.Conclusions In this pilot study, the new regimen containing RAL, TDF and 3TC appears to be an ideal option for patients on methadone maintenance therapy, because of its limited impact on methadone dose and good efficacy and safety profile.
ABSTRACT
Objective To examine the prevalence and correlates for needle-sharing among new and long-term injection drug users (IDUs) in Sichuan province, China. Methods Three consecutive cross-sectional surveys were conducted in 6 prefectures of Sichuan province, from 2003 to 2005.Questionnaire-based interviews provided information including socio-demographics, drug-use, sexual behaviors, and HIV-related services. Multivariable logistic regression methodology was used for data analysis. Results Of 3852 eligible participants, the rates of needle-sharing in the last 6 months for IDUs with a less than one year, one to three year, and more than three year injection history were 19.9%,29.1%, and 36.3%, respectively. Needle-sharing for IDUs with a less than one-year injection history was independently associated with factors as: being female, having minority background, higher frequency of injection, sharing injecting equipments, ever having had a non-regular sex partner, or a regular sex partner who injected drugs, never had a test on HIV, being recruited in 2005, and from Zigong prefectm'es of Sichuan. Needle-sharing for IDUs with a 1-3 year injection history were independently associated with receiving less education, having higher frequency of injecting behavior, sharing injecting equipments,ever having had a non-regular sex partner/a regular sex partner who injected drugs, ever having had unprotected sex with a non-regular sex partner, ever having had unprotected sex with a commercial sex partner or client, never attended skill training for HIV/STD prevention, being recruited in 2005 and 2004,and being recruited from Deyang, Zigong, and Liangshan prefectures. Needle-sharing for IDUs with a more than three-year injection history was independently associated with factors as: less education, higher frequency of injecting, sharing injecting equipment, ever had a non-regular sex partner, ever had unprotected sex with a non-regular sex partner, ever had unprotected sex with a commercial sex partner or client, having had regular sex partners who inject drugs, never attended needle exchange programs, being recruited in 2005 and 2004, and being recruited from Deyang, Zigong, and Liangshan prefectures. Conclusion The rates for both needle/paraphernalia sharing and unprotected sex behaviors were high in the IDUs in Sichuan province. These rates were higher among longer-term IDUs than in new IDUs. Our data underlined that better targeted, in-depth and sustained comprehensive intervention packages which including needle exchange, condom promotion along with distribution, and education, were urgently needed to reduce both IDU-related and sex-related risk behaviors among both new and longer term IDUs.
ABSTRACT
Background & objectives: Prevalence of injection drug users (IDUs) is high in the northeastern region of India. This coupled with unsafe injecting practices as well as practice of tattooing in remote tribal areas call for baseline data on the prevalence of parentally transmitted viral diseases. In the present study we aimed to measure the risk behaviours and seroprevalence of hepatitis C virus (HCV) antibodies amongst IDUs of Mizoram, a State of the northeast India. Methods: A cross-sectional study was conducted in 2004-2005 amongst IDUs (including female sex workers) who had injected in the past six months and were unaware of their HCV/HIV status. They were recruited from various drop-in centers from Aizawl, Mizoram, and screened for anti-HCV antibodies using 3rd generation HCV EIA and recombinant immunoblot assay (RIBA). Results: The prevalence of HCV antibodies was 71.2 per cent among the active IDUs. On univariate analysis increasing duration of injection, syringe sharing and heroin (diacetylmorphine) injectors were at a significantly higher risk of acquiring HCV antibodies (P<0.001). On multivariate analysis, HCV antibody prevalence showed a strong association with the type of drugs injected (P=0.001), frequency of injecting (P=0.013), multiplicity of drugs abused (P=0.004), and needle syringe sharing (P=0.003). Interpretation & conclusions: Unsafe injecting practices were found to be associated with a higher risk of acquiring hepatitis C infection. Our findings showed that syringe and needle exchange programme alone was not sufficient as a preventive strategy for control of hepatitis C infection among IDUs of Aizawl.