Study analyzes link between HIV infection and overdose risk

December 12, 2011 in HIV & AIDS

A study from Rhode Island Hospital is the first to systematically review and analyze the literature on the association between HIV infection and overdose risk. The findings show a 74 percent greater risk of overdose among drug users if they are HIV-infected. The researchers found that reasons for the increased risk are biological and behavioral, but may also include environmental and structural factors. The study is now available online in advance of print in the journal AIDS.

Drug overdose is a common cause of non-AIDS death among people with and is the leading cause of death for people who inject drugs. People with HIV are often exposed to opioid medication as part of their treatment, while others may continue to use illicit despite their disease status. Both scenarios present a heightened risk for fatal and non-fatal overdose. While the association between and injection drug use has been well documented, the potential association between HIV and overdose has received less attention.

With this in mind, Traci Green, Ph.D., M.Sc., a researcher with Rhode Island Hospital and the Lifespan//Brown Center for AIDS Research, led a study to systematically review the literature on the putative association of HIV infection with overdose, meta-analyze the results and explore the causes.

Green reports that 46 studies were reviewed, and 24 of those reported data that were sufficient for inclusion in their analysis. Based on those studies, Green says, "Our results suggest that people who use drugs have a 74 percent greater risk of overdose if they are HIV-infected compared to their counterparts who are not HIV-infected. Over the past 30 years, we have made impressive strides in caring for and prolonging the lives of people with HIV. Our study found that by overdose is an issue that affects people with HIV disproportionately."

"It is not entirely clear why the risk is greater, and few studies have endeavored to figure out why this might be happening," Green points out. Biological explanations for the association could include clinical status, immunosuppression, opportunistic infections and poorer physical health in this population, while several studies posit that conditions that affect body's ability to metabolize, like hepatitis C infection, may also increase the risk of overdose. Behavioral factors include high-risk lifestyles and psychiatric comorbidities that might be greater among HIV-infected than HIV-uninfected .

Green further explains that other reasons for the association may include factors such as poor access to medication-assisted therapy to treat opioid dependence, homelessness and poverty, which may contribute to a higher risk of overdose.

Through their research, Green reports that there are ways to reduce the increased risk of overdose among this population. Green comments, "The good news is that we already have several cost-effective overdose prevention tools to call upon. The first is access to highly active antiretroviral therapy (HAART) medications, prescribed by providers prepared to prevent and manage potential interactions between antiretrovirals and drugs with abuse potential. The second is medication-assisted therapy, and in particular, methadone and buprenorphine therapies, which have been shown to protect against fatal overdose. The third tool is distribution of Naloxone (Narcan), a prescription medication with no abuse potential that reverses an opioid overdose, to people who are HIV positive and use opiates.

Green adds, "Bringing overdose awareness and prevention into the HIV care setting is critical to reducing overdose deaths. Health care providers who treat HIV-infected patients with a history of substance abuse or who are taking opioid medications should consider counseling patients on how to reduce their risk of overdose. They may also consider prescribing Naloxone to patients, or offering a referral to MAT to reduce the risk of ."

Provided by Lifespan search and more info website

not rated yet  

Rank not rated yet
Relevant PhysicsForums posts

More news stories

Mortality rates decrease, chronic disease rates increase among HIV+ ICU patients

The expanded use of antiretrovirals, potent drugs used to treat retroviral infections such as human immunodeficiency virus (HIV), has been linked to significant decreases in hospital mortality rates among severely ill HIV-positive(HIV+) ...

HIV & AIDS created May 23, 2012 | popularity not rated yet | comments 0

Newly discovered breast milk antibodies help neutralize HIV

Antibodies that help to stop the HIV virus have been found in breast milk. Researchers at Duke University Medical Center isolated the antibodies from immune cells called B cells in the breast milk of infected mothers in Malawi, ...

HIV & AIDS created May 22, 2012 | popularity 5 / 5 (3) | comments 1 | with audio podcast

Reactions to HIV drug have autoimmune cause, reports AIDS journal

Potentially severe hypersensitivity reactions to the anti-HIV drug abacavir occur through an autoimmune mechanism, resulting from the creation of drug-induced immunogens that are attacked by the body's immune system, according ...

HIV & AIDS created May 22, 2012 | popularity 5 / 5 (1) | comments 0

Is the U.S. ready for home HIV tests?

At the pharmacy, you can buy anything from tea kettles to Tylenol. But what if you could buy a rapid HIV test over the counter and test yourself in the privacy of your own home?

HIV & AIDS created May 21, 2012 | popularity not rated yet | comments 0 | with audio podcast

Reduced glycerin formulation of tenofovir vaginal gel safe for rectal use

A change in the formulation of tenofovir gel, an anti-HIV gel developed for vaginal use, may make it safer to use in the rectum, suggests a study published online this week in the Journal of Antimicrobial Chemotherapy. In lab ...

HIV & AIDS created May 17, 2012 | popularity 5 / 5 (1) | comments 0


Travel to high altitudes tied to Crohn's, colitis flare-ups

(HealthDay) -- People with inflammatory bowel disease, which includes Crohn's disease and colitis, may be at increased risk for flare-ups when they fly or travel to high altitudes for skiing or mountain climbing, ...

Family history of Alzheimer's affects functional connectivity

(HealthDay) -- Cognitively normal individuals with a family history of late-onset Alzheimer's disease (AD) may display lower resting state functional connectivity in the default mode network (DMN) of the brain, ...

Transvaginal mesh op restores pelvic organ prolapse at price

(HealthDay) -- Transvaginal mesh (TVM) procedures are effective for anatomical restoration of pelvic organ prolapse (POP), but patients report a worsening of sexual function following surgery, according to ...

Of mice and mental models: Neuroscientific implications of risk-optimized behavior in the mouse

(Medical Xpress) -- Regardless of an organism’s biological complexity, every encephalized animal continuously makes under-informed behavioral choices that can have serious consequences. Despite its ubiquity, ...

Weight struggles? Blame new neurons in your hypothalamus

New nerve cells formed in a select part of the brain could hold considerable sway over how much you eat and consequently weigh, new animal research by Johns Hopkins scientists suggests in a study published in the May issue ...

Thioridazine kills cancer stem cells in human while avoiding toxic side-effects of conventional cancer treatments

A team of scientists at McMaster University has discovered a drug, thioridazine, successfully kills cancer stem cells in the human while avoiding the toxic side-effects of conventional cancer treatments.