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Current drug use and lack of HIV virologic suppression: point-of-care urine drug screen versus self-report
BACKGROUND: There have been inconsistent findings on the association between current drug use and HIV disease progression and virologic suppression. Drug use was often measured using self-report of historical use. Objective measurement of current drug use is preferred. METHODS: In this cross-section...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4175271/ https://www.ncbi.nlm.nih.gov/pubmed/25234368 http://dx.doi.org/10.1186/1471-2334-14-508 |
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author | Qian, Han-Zhu Mitchell, Valerie J Bebawy, Sally Cassell, Holly Perez, Gina McGowan, Catherine C Sterling, Timothy R Vermund, Sten H D’Aquila, Richard Hulgan, Todd |
author_facet | Qian, Han-Zhu Mitchell, Valerie J Bebawy, Sally Cassell, Holly Perez, Gina McGowan, Catherine C Sterling, Timothy R Vermund, Sten H D’Aquila, Richard Hulgan, Todd |
author_sort | Qian, Han-Zhu |
collection | PubMed |
description | BACKGROUND: There have been inconsistent findings on the association between current drug use and HIV disease progression and virologic suppression. Drug use was often measured using self-report of historical use. Objective measurement of current drug use is preferred. METHODS: In this cross-sectional study, we assessed drug use through Computer-Assisted Self Interviews (CASI) and point-of-care urine drug screen (UDS) among 225 HIV-infected patients, and evaluated the association between current drug use and virologic suppression. RESULTS: About half (54%) of participants had a positive UDS, with a lower self-reported rate by CASI (42%) (Kappa score = 0.59). By UDS, 36.0% were positive for marijuana, 25.8% for cocaine, 7.6% for opiates, and 2.2% for methamphetamine or amphetamine. Factors associated with virologic suppression (plasma HIV RNA <50 copies/mL) were Caucasian race (P = 0.03), higher CD4 count (P < 0.01), current use of antiretroviral therapy (ART) (P < 0.01), and a negative UDS (P < 0.01). Among 178 current ART users, a positive UDS remained significantly associated with lower likelihood of virologic suppression (P = 0.04). CONCLUSIONS: UDS had good agreement with CASI in detecting frequently used drugs such as marijuana and cocaine. UDS at routine clinic visits may provide “real-time” prognostic information to optimize management. |
format | Online Article Text |
id | pubmed-4175271 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-41752712014-09-27 Current drug use and lack of HIV virologic suppression: point-of-care urine drug screen versus self-report Qian, Han-Zhu Mitchell, Valerie J Bebawy, Sally Cassell, Holly Perez, Gina McGowan, Catherine C Sterling, Timothy R Vermund, Sten H D’Aquila, Richard Hulgan, Todd BMC Infect Dis Research Article BACKGROUND: There have been inconsistent findings on the association between current drug use and HIV disease progression and virologic suppression. Drug use was often measured using self-report of historical use. Objective measurement of current drug use is preferred. METHODS: In this cross-sectional study, we assessed drug use through Computer-Assisted Self Interviews (CASI) and point-of-care urine drug screen (UDS) among 225 HIV-infected patients, and evaluated the association between current drug use and virologic suppression. RESULTS: About half (54%) of participants had a positive UDS, with a lower self-reported rate by CASI (42%) (Kappa score = 0.59). By UDS, 36.0% were positive for marijuana, 25.8% for cocaine, 7.6% for opiates, and 2.2% for methamphetamine or amphetamine. Factors associated with virologic suppression (plasma HIV RNA <50 copies/mL) were Caucasian race (P = 0.03), higher CD4 count (P < 0.01), current use of antiretroviral therapy (ART) (P < 0.01), and a negative UDS (P < 0.01). Among 178 current ART users, a positive UDS remained significantly associated with lower likelihood of virologic suppression (P = 0.04). CONCLUSIONS: UDS had good agreement with CASI in detecting frequently used drugs such as marijuana and cocaine. UDS at routine clinic visits may provide “real-time” prognostic information to optimize management. BioMed Central 2014-09-18 /pmc/articles/PMC4175271/ /pubmed/25234368 http://dx.doi.org/10.1186/1471-2334-14-508 Text en © Qian et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Qian, Han-Zhu Mitchell, Valerie J Bebawy, Sally Cassell, Holly Perez, Gina McGowan, Catherine C Sterling, Timothy R Vermund, Sten H D’Aquila, Richard Hulgan, Todd Current drug use and lack of HIV virologic suppression: point-of-care urine drug screen versus self-report |
title | Current drug use and lack of HIV virologic suppression: point-of-care urine drug screen versus self-report |
title_full | Current drug use and lack of HIV virologic suppression: point-of-care urine drug screen versus self-report |
title_fullStr | Current drug use and lack of HIV virologic suppression: point-of-care urine drug screen versus self-report |
title_full_unstemmed | Current drug use and lack of HIV virologic suppression: point-of-care urine drug screen versus self-report |
title_short | Current drug use and lack of HIV virologic suppression: point-of-care urine drug screen versus self-report |
title_sort | current drug use and lack of hiv virologic suppression: point-of-care urine drug screen versus self-report |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4175271/ https://www.ncbi.nlm.nih.gov/pubmed/25234368 http://dx.doi.org/10.1186/1471-2334-14-508 |
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