Abstract
Background: Whether HIV-positive injecting drug users (IDUs) are at higher risk of developing drug resistance mutations (DRMs) after methadone maintenance therapy (MMT) than any other HIV-positive population is unclear.
Objective: To compare the incidence of new DRMs in two population groups: antiretroviraltreatment (ART) HIV-positive IDUs and non-drug users. Methods: A prospective cohort of ART HIV-positive patients including IDUs who received MMT (MMT group) and non-drug users (N-MMT group) was established from April 2016 to December 2017 in Guangxi, China. Results: Of the 80 participants, 43 were in the MMT group and 37 were in the N-MMT group. Compared with the N-MMT group, the HRs of PIs, NRTIs and NNRTIs for new DRMs in the MMT group was 1.55 (95%CI: 0.28-8.64; P = 0.616), 1.51 (95%CI: 0.44-5.20; P = 0.512) and 0.45 (95%CI: 0.15-1.35; P = 0.155), respectively. There was no dose-response relationship between MMT and new DRMs for PIs, NRTIs and NNRTIs (P > 0.05). The new DRM incidence for NRTIs (138.23 per 104 person-months) was higher than for PIs (94.16 per 104 person-months) and NNRTIs (95.41per 104 person-months) in the MMT group, while the new DRM incidence for NNRTIs (208.24 per 104 person-months) was higher than for PIs (44.13 per 104 person-months) and NRTIs (91.78 per 104 person-months) in the N-MMT group. Conclusion: Among ART HIV-positive patients, there is no significant difference in the incidence of new DRMs between IDUs receiving MMT and non-drug users. MMT has little impact on the development of DRMs among IDUs.Keywords: HIV-positive, methadone maintenance therapy, injecting drug users, antiretroviral-treatment, drug resistance mutations, cohort study.
Graphical Abstract
[http://dx.doi.org/10.1097/QAD.0b013e3283324283] [PMID: 19770621]
[http://dx.doi.org/10.1016/S0140-6736(10)60936-1] [PMID: 20638713]
[http://dx.doi.org/10.1097/QAD.0b013e32835521a3] [PMID: 22706009]
[http://dx.doi.org/10.1016/S1473-3099(13)70692-3] [PMID: 24602844]
[http://dx.doi.org/10.1097/QAI.0b013e31829ceb14] [PMID: 23756374]
[http://dx.doi.org/10.1016/S2221-1691(13)60106-9] [PMID: 23835806]
[http://dx.doi.org/10.1371/journal.pone.0166661] [PMID: 27997554]
[http://dx.doi.org/10.1089/aid.2012.0182] [PMID: 22856626]
[http://dx.doi.org/10.1016/j.drugalcdep.2012.05.028] [PMID: 22726912]
[http://dx.doi.org/10.1016/j.drugpo.2006.11.014] [PMID: 17689354]
[http://dx.doi.org/10.1016/j.healthplace.2008.09.011] [PMID: 19083260]
[http://dx.doi.org/10.1258/0956462001916137] [PMID: 10919490]
[http://dx.doi.org/10.1097/01.aids.0000172879.20628.e1] [PMID: 15930843]
[http://dx.doi.org/10.1002/jmv.20621] [PMID: 16628575]
[http://dx.doi.org/10.1186/s12981-015-0070-y] [PMID: 26279669]
[http://dx.doi.org/10.1136/bmjopen-2014-005886] [PMID: 25319999]
[http://dx.doi.org/10.1093/jac/dku473] [PMID: 25433009]
[http://dx.doi.org/10.1089/aid.2010.0013] [PMID: 20860532]
[http://dx.doi.org/10.1097/00002030-200001280-00003] [PMID: 10708278]
[http://dx.doi.org/10.1179/0001551213Z.0000000001] [PMID: 24635391]
[http://dx.doi.org/10.1097/00002030-200411050-00011] [PMID: 15577652]
[http://dx.doi.org/10.1097/01.qai.0000159666.95455.d2] [PMID: 16123691]
[http://dx.doi.org/10.1097/QAI.0b013e318198a619] [PMID: 19214121]
[http://dx.doi.org/10.1097/00126334-200401010-00006] [PMID: 14707791]
[http://dx.doi.org/10.1093/jac/dkn002] [PMID: 18227088]
[http://dx.doi.org/10.1093/jac/dku372] [PMID: 25248322]
[http://dx.doi.org/10.1086/420789] [PMID: 15181563]
[http://dx.doi.org/10.1097/01.aids.0000131357.52457.33] [PMID: 15238775]
[http://dx.doi.org/10.1016/j.virusres.2005.03.004] [PMID: 16022906]
[http://dx.doi.org/10.1097/01.aids.0000176219.48484.f1] [PMID: 15990572]
[http://dx.doi.org/10.1159/000499367] [PMID: 31018203]
[http://dx.doi.org/10.1097/MD.0000000000013323] [PMID: 30461647]
[http://dx.doi.org/10.1002/14651858.CD002209.pub2] [PMID: 19588333]
[http://dx.doi.org/10.1080/10550887.2010.531672] [PMID: 21218308]
[http://dx.doi.org/10.3310/hta11090] [PMID: 17313907]
[http://dx.doi.org/10.1111/j.1360-0443.2008.02249.x] [PMID: 18636999]
[http://dx.doi.org/10.1016/j.neulet.2014.08.026] [PMID: 25157798]
[http://dx.doi.org/10.1016/j.drugalcdep.2015.08.037] [PMID: 26455554]
[http://dx.doi.org/10.1002/14651858.CD004145.pub4] [PMID: 21833948]
[PMID: 27066590]
[http://dx.doi.org/10.1016/S0306-4603(01)00279-9] [PMID: 12726791]
[http://dx.doi.org/10.1007/BF02386744] [PMID: 10976608]
[PMID: 25598787]
[http://dx.doi.org/10.2471/BLT.12.108944] [PMID: 23554522]
[PMID: 19920294]
[http://dx.doi.org/10.1111/j.1360-0443.2010.02905.x] [PMID: 20331553]
[http://dx.doi.org/10.1086/630209] [PMID: 19807275]
[http://dx.doi.org/10.1016/j.drugalcdep.2016.09.013] [PMID: 27701042]
[http://dx.doi.org/10.1007/s10461-013-0584-z] [PMID: 23918244]
[http://dx.doi.org/10.1186/s12879-015-1255-7] [PMID: 26586238]
[http://dx.doi.org/10.1016/j.drugalcdep.2006.02.003] [PMID: 16542797]
[http://dx.doi.org/10.1016/S0140-6736(10)60832-X] [PMID: 20650513]
[http://dx.doi.org/10.1080/10550887.2012.694598] [PMID: 22873183]
[http://dx.doi.org/10.1081/ADA-100100600] [PMID: 10852356]
[http://dx.doi.org/10.1097/01.aids.0000199825.34241.49] [PMID: 16511415]
[http://dx.doi.org/10.1097/QAD.0b013e3282f366ff] [PMID: 18090394]
[PMID: 28208121]
[http://dx.doi.org/10.1016/S0140-6736(08)61311-2] [PMID: 18817968]
[http://dx.doi.org/10.1016/S2214-109X(17)30375-3] [PMID: 29074409]
[http://dx.doi.org/10.1111/add.12970] [PMID: 25940906]
[http://dx.doi.org/10.1097/QAI.0b013e318050d61f] [PMID: 17527095]
[http://dx.doi.org/10.3109/00952999409106017] [PMID: 7977217]
[http://dx.doi.org/10.1086/338011] [PMID: 11756991]
[http://dx.doi.org/10.1097/00007691-200110000-00010] [PMID: 11591903]
[http://dx.doi.org/10.1097/00042560-200007010-00008] [PMID: 10969348]
[http://dx.doi.org/10.1038/clpt.2011.276] [PMID: 22398970]
[http://dx.doi.org/10.1080/10550490500419029] [PMID: 16449090]
[http://dx.doi.org/10.1371/journal.pone.0205119] [PMID: 30286160]
[http://dx.doi.org/10.1371/journal.pone.0117430] [PMID: 25635815]
[http://dx.doi.org/10.1016/j.jcv.2016.07.007] [PMID: 27472519]
[http://dx.doi.org/10.1159/000431093] [PMID: 26139571]
[http://dx.doi.org/10.1111/j.1468-1293.2009.00814.x] [PMID: 20163482]
[http://dx.doi.org/10.2174/1874285801711010045] [PMID: 28553415]
[http://dx.doi.org/10.1093/jac/dku395] [PMID: 25344807]
[http://dx.doi.org/10.1016/j.jcv.2019.104207] [PMID: 31707202]
[http://dx.doi.org/10.1371/journal.pone.0185559] [PMID: 28953964]