Relación entre la adherencia al tratamiento antirretroviral en pacientes VIH+ y el consumo de alcohol, asociado o no al uso de otras sustancias

  1. Sara González-Álvarez 1
  2. Agustín Madoz-Gúrpide 2
  3. Carlos Parro-Torres 3
  4. Daniel Hernández-Huerta 1
  5. Enriqueta Ochoa Mangado 4
  1. 1 Servicio de Psiquiatría, Hospital Universitario Ramón y Cajal
  2. 2 Centro de Salud Mental San Blas. Servicio de Psiquiatría, Hospital Universitario Ramón y Cajal (IRYCIS). Universidad de Alcalá
  3. 3 Servicio de Psiquiatría, Hospital General Universitario Gregorio Marañón
  4. 4 Servicio de Psiquiatría, Hospital Universitario Ramón y Cajal (IRYCIS). Universidad de Alcalá
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Revue:
Adicciones: Revista de socidrogalcohol

ISSN: 0214-4840

Année de publication: 2019

Volumen: 31

Número: 1

Pages: 8-17

Type: Article

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D'autres publications dans: Adicciones: Revista de socidrogalcohol

Résumé

Hazardous alcohol consumption is a common diagnosis among people living with HIV infection. The relationship between alcohol consumption and poor adherence to antiretroviral therapy has been highlighted in different studies, yet few of them performed a parallel analysis of other substance use. In Spain, alcohol consumption is frequently associated with other substance use, mainly cannabis and cocaine. The aim of this study is to assess the influence of hazardous alcohol consumption both combined with other substances (cocaine, heroin, methadone and/or cannabis) or alone on antiretroviral therapy adherence in our social environment. We performed an observational case-control study including 119 HIV+ individuals. We recruited 40 non-adherent patients, defined by less than 90% compliance according to hospital pharmacy refill data, and corroborated by the Simplified Medication Adherence Questionnaire (SMAQ) and referring professional’s opinion. Control cases (n=79) were defined as those patients with similar characteristics but considered adherent according to the same parameters. Data collection took place between May 2013 and September 2015. Statistical analysis was performed using a binary logistic regression model. Our results indicate that alcohol consumption decreases adherence to antiretroviral therapy. The use of methadone represents a statistically significant increased risk of poor adherence. No significant differences were found between adherent and non-adherent groups regarding cocaine, heroin or cannabis use in this study. In summary, the detection of substance use and especially alcohol consumption in HIV+ patients can improve the effectiveness of antiretroviral therapy by identifying and treating at-risk individuals for a poor therapeutic adherence.

Références bibliographiques

  • Ammassari, A., Trotta, M.P., Murri, R., Castelli, F., Narciso, P, Noto, P., ... Antinori A. (2002). Correlates and predictors of adherence to highly active antiretroviral therapy: overview of published literature. Journal of Acquired Immune Deficiency Syndromes, 31, S123-127.
  • Anand, P., Springer, S.A., Copenhaver, M.M. y Altice, F.L. (2010). Neurocognitive impairment and HIV risk factors: a reciprocal relationship. AIDS and Behavior, 14, 1213-1226. doi:10.1007/s10461-010-9684-1.
  • Azar, M.M., Springer, S.A., Meyer, J.P. y Altice, F.L. (2010). A systematic review of the impact of alcohol use disorders on HIV treatment outcomes, adherence to antiretroviral therapy and health care utilization. Drug and Alcohol Dependence, 112, 178-193. doi:10.1016/j.drugalcdep.2010.06.014.
  • Azar, P., Wood, E., Nguyen, P., Luma, M., Montaner, J., Kerr, T. y Milloy, M.J. (2015). Drug use patterns associated with risk of non-adherence to antiretroviral therapy among HIV-positive illicit drug users in a Canadian setting: a longitudinal analysis. BMC Infectious Diseases, 15, 193. doi:10.1186/s12879-015-0913-0.
  • Baum, M.K., Rafie, C., Lai, S., Sales, S., Page, J.B. y Campa, A. (2010). Alcohol use accelerates HIV disease progression. AIDS Research and Human Retroviruses, 26, 511–518. doi:10.1089/aid.2009.0211.
  • Beer, L., Mattson, C.L., Bradley, H. y Skarbinski, J. (2016). Medical Monitoring Project. Understanding cross-sectional racial, ethnic, and gender disparities in antiretroviral use and viral suppression among HIV patients in the United States. Medicine, 95, e3171. doi:10.1097/ MD.0000000000003171.
  • Berg, K.M. y Arnsten, J.H. (2006). Practical and conceptual challenges in measuring antiretroviral adherence. Journal of Acquired Immune Deficiency Syndromes, 43, S79-S87. doi:10.1097/01.qai.0000248337.97814.66.
  • Bermudez, L.G., Jennings, L., Ssewamala, F.M., Nabunya, P., Mellins, C. y McKay, M. (2016). Equity in adherence to antiretroviral therapy among economically vulnerable adolescents living with HIV in Uganda. AIDS Care, 28, 83-91. doi:10.1080/09540121.2016.1176681.
  • Binford, M.C., Kahana, S.Y. y Altice, F.L. (2012). A systematic review of antiretroviral adherence interventions for HIV-infected people who use drugs. Current HIV/AIDS Reports, 9, 287-312. doi:10.1007/s11904-012-0134-8.
  • Braithwaite, R.S. y Bryant, K.J. (2010). Influence of alcohol consumption on adherence to and toxicity of antiretroviral therapy and survival. Alcohol Research and Health, 33, 280-287.
  • Cohen, C.J. (2006). Successful HIV treatment: lessons learned. Journal of Managed Care & Specialty Pharmacy, 12, S6-S11. doi:10.18553/jmcp.2006.12.S7-B.S6
  • Cortés Tomás, M.T. y Motos Sellés, P. (2016). Cómo definir y medir el consumo intensivo de alcohol. En M.T. Cortés Tomás (Coord.) Consumo intensivo de alcohol en jóvenes. Guía Clínica (pp. 25-46), España: Socidrogalcohol.
  • De Jong, B.C., Prentiss, D., McFarland, W., Machekano, R. e Israelski, D.M. (2005). Marijuana use and its association with adherence to antiretroviral therapy among HIV-infected persons with moderate to severe nausea. Journal of Acquired Immune Deficiency Syndromes, 38, 43–46.
  • Galvan, F.H., Bing, E.G., Fleishman, J.A., London, A.S., Caetano, R., Burnam, M.A., … Shapiro, M. (2002). The prevalence of alcohol consumption and heavy drinking among people with HIV in the United States: results from the HIV Cost and Services Utilization Study. Journal of Studies on Alcohol and Drugs, 63, 179-186.
  • Gonzalez, A., Barinas, J. y O’Cleirigh, C. (2011). Substance use: impact on adherence and HIV medical treatment. Current HIV/AIDS Reports, 8, 223-234. doi:10.1007/ s11904-011-0093-5.
  • Gonzalez, A., Mimiaga, M.J., Israel, J., Andres Bedoya, C. y Safren, S.A. (2013). Substance use predictors of poor medication adherence: the role of substance use coping among HIV-infected patients in opioid dependence treatment. AIDS and Behavior, 17, 168-173. doi:10.1007/ s10461-012-0319-6.
  • Hendershot, C.S., Stoner, S.A., Pantalone, D.W. y Simoni, J.M. (2009). Alcohol use and antiretroviral adherence: review and meta-Analysis. Journal of Acquired Immune Deficiency Syndromes, 52, 180-202. doi:10.1097/QAI.0b013e3181b18b6e.
  • Henegar, C.E., Westreich, D., Maskew, M., Brookhart, M.A., Miller, W.C., Majuba, P. y Van Rie, A. (2015). Comparison of pharmacy-based measures of adherence to antiretroviral therapy as predictors of virological failure. AIDS and Behaviour, 19, 612-618. doi:10.1007/s10461014-0953-2.
  • Hinkin, C.H., Hardy, D.J., Mason, K.I., Castellon, S.A., Durvasula, R.S., Lam, M.N. y Stefaniak, M. (2004). Medication adherence in HIV-infected adults: effect of patient age, cognitive status, and substance abuse. AIDS, 18, S19-S25.
  • Hudelson, C. y Cluver, L. (2015). Factors associated with adherence to antiretroviral therapy among adolescents living with HIV/AIDS in lowand middle-income countries: a systematic review. AIDS Care, 27, 805-816. doi:10. 1080/09540121.2015.1011073.
  • Hutton, H.E. y Treisman, G. (2008). The Role of Personality in HIV Risk Behaviors: Implications for Treatment. En M.A. Cohen y J.M. Gorman (Ed.), Comprehensive Textbook of AIDS Psychiatry (pp. 141–149). Nueva York: Oxford University Press.
  • Instituto de Salud Carlos III, Área de Vigilancia de VIH y Comportamientos de Riesgo (2016). Vigilancia Epidemiológica del VIH y sida en España: Sistema de Información sobre Nuevos Diagnósticos de VIH y Registro Nacional de Casos de Sida. Plan Nacional sobre el Sida S.G. de Promoción de la Salud y Epidemiología / Centro Nacional de Epidemiología ISCIII. Madrid.
  • Kalichman, S.C., Kalichman, M.O., Cherry, C., Hoyt, G., Washington, C., Grebler, T., … Merely, C. (2015). Intentional Medication Nonadherence Because of Interactive Toxicity Beliefs Among HIV-Positive Active Drug Users. Journal of Acquired Immune Deficiency Syndromes, 70, 503509. doi:10.1097/QAI.0000000000000776.
  • Knobel, H., Alonso, J., Casado, J.L., Collazos, J., González, J., Ruiz, I., … Ocampo, A. (2002). Validation of a simplified medication adherence questionnaire in a large cohort of HIV-infected patients: the GEEMA Study. AIDS, 16, 605-613.
  • Ladero, L., Orejudo, S. y Carrobles, J.A. (2005). Variables psicosociales en la adherencia al tratamiento antirretroviral en pacientes adscritos a un programa de mantenimiento con metadona. Psicothema, 17, 575-581.
  • Lazo, M., Gange, S.J., Wilson, T.E., Anastos, K., Ostrow, D.G., Witt, M.D. y Jacobson, L.P. (2007). Patterns and predictors of changes in adherence to highly active antiretroviral therapy: longitudinal study of men and women. Clinical Infectious Diseases, 45, 1377-1385. doi:10.1086/522762.
  • Lucas, G.M., Gebo, K.A., Chaisson, R.E. y Moore, R.D. (2002). Longitudinal assessment of the effects of drug and alcohol abuse on HIV-1 treatment outcomes in an urban clinic. AIDS, 16, 767-774.
  • Malta, M., Strathdee, S.A., Magnanini, M.M.F. y Bastos, F.I. (2008). Adherence to antiretroviral therapy for human immunodeficiency virus/acquired immune deficiency syndrome among drug users: a systematic review. Addiction, 103, 1242–1257. doi:10.1111/j.13600443.2008.02269.x.
  • Nachega, J.B., Parienti, J.J., Uthman, O.A., Gross, R., Dowdy, D.W., Sax, P.E., … Giordano, T.P. (2014). Lower pill burden and once-daily antiretroviral treatment regimens for HIV infection: A meta-analysis of randomized controlled trials. Clinical Infectious Diseases, 58, 12971307. doi:10.1093/cid/ciu046.
  • Observatorio Español de la Droga y las Toxicomanías (OEDT), Delegación del Gobierno para el Plan Nacional sobre Drogas (DGPNSD) y Ministerio de Sanidad, Servicios Sociales e Igualdad (MSSS), (2015). EDADES. Encuesta sobre Alcohol y Drogas en España. Recuperado de http://www.pnsd.msssi.gob.es/ca/profesionales/sistemasInformacion/sistemaInformacion/pdf/2015_Informe_EDADES.pdf.
  • Organización Mundial de la Salud (O.M.S), (1992). CIE10. Décima Revisión de la Clasificación Internacional de Enfermedades. Trastornos Mentales y del Comportamiento. Madrid: Meditor.
  • Ortego, C., Huedo-Medina, T.B., Vejo, J. y Llorca, F.J. (2011). Adherence to highly active antiretroviral therapy in Spain: A meta-analysis.  Gaceta Sanitaria,  25, 282328. doi:10.1016/j.gaceta.2010.10.016.
  • Palepu, A., Horton, N.J., Tibbetts, N., Meli, S. y Samet, J.H. (2004). Uptake and adherence to highly active antiretroviral therapy among HIV-infected people with alcohol and other substance use problems: the impact of substance abuse treatment. Addiction, 99, 361-368.
  • Parry, C. D., Morojele, N. K., Myers, B. J., Kekwaletswe, C. T., Manda, S. O., Sorsdahl, K., … Shuper, P. A. (2014). Efficacy of an alcohol-focused intervention for improving adherence to antiretroviral therapy (ART) and HIV treatment outcomes – a randomised controlled trial protocol. BMC Infectious Diseases, 14, 500. doi:10.1186/14712334-14-500.
  • Parsons, J.T., Starks, T.J., Millar, B.M., Boonrai, K. y Marcotte, D. (2014). Patterns of substance use among HIV-positive adults over 50: implications for treatment and medication adherence. Drug and Alcohol Dependence, 139, 33-40. doi:10.1016/j.drugalcdep.2014.02.704.
  • Paterson, D.L., Swindells, S., Mohr, J., Brester, M., Vergis, E.N., Squier, C.,… Singh,N. (2000). Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Annals of Internal Medicine, 133, 21-30.
  • Peltzer, K. y Pengpid, S. (2013). Socioeconomic factors in adherence to HIV therapy in lowand middle-income countries. Journal of Health, Population and Nutrition, 31, 150-170.
  • Pérez-Valero, I., Hontañón-Antoñana, V., Cáceres, G., Montes, J., Montes-Ramírez, M., Bernardino, I., … González Baeza, A. (2016a). High rates of alcohol consumption among HIV-infected patients and poorer ART adherence in those patients with risky alcohol intake. Póster presentado al VIII Congreso Nacional Grupo de Estudio de Sida. San Sebastián, España. Recuperado de https://intranet.pacifico-meetings.com/amsysweb/faces/publicacionOnline.xhtml?id=324.
  • Pérez-Valero, I., Hontañón-Antoñana, V., Montes, J., Cáceres, G., Valencia, E., Martín-Carbonero, L.,… González Baeza, A. (2016b). Poorer antiretroviral treatment outcomes and higher anxiety levels associated to illicit drug consumption among HIV-infected patients attended in Spain. Póster presentado al VIII Congreso Nacional Grupo de Estudio de Sida. San Sebastián, España. Recuperado de https:// intranet.pacifico-meetings.com/amsysweb/faces/publicacionOnline.xhtml?id=324.
  • Poorolajal, J., Hooshmand, E., Mahjub, H., Esmailnasab, N. y Jenabi, E. (2016). Survival rate of AIDS disease and mortality in HIV-infected patients: a meta-analysis. Public Health, 139, 3-12. doi:10.1016/j.puhe.2016.05.004.
  • Rosen, M.I., Black, A.C., Arnsten, J.H., Goggin, K., Remien, R.H., Simoni, J.M., … Liu, H. (2013). Association between use of specific drugs and antiretroviral adherence: findings from MACH 14. AIDS and Behavior, 17, 142147. doi:10.1007/s10461-011-0124-7.
  • Ruiz-Pérez, I., Olry de Labry-Lima, A., Prada-Pardal, J.L., Rodríguez-Baño, J., Causse-Prados, M., López-Ruz, M.A., … Morales-Rojas, D. (2006). Impacto de los factores demográficos y psicosociales en la no adherencia a los fármacos antirretrovirales. Enfermedades Infecciosas y Microbiología Clínica, 24, 373-378.
  • Scott-Sheldon, L. A. J., Walstrom, P., Carey, K. B., Johnson, B. T., Carey, M. P. y the MASH Research Team. (2013). Alcohol Use and Sexual Risk Behaviors among Individuals Infected with HIV: A Systematic Review and Meta-Analysis 2012 to Early 2013. Current HIV/AIDS Reports, 10, 314–323. doi:10.1007/s11904-013-0177-5.
  • Skalski, L.M., Sikkema, K.J., Heckman, T.G. y Meade, C.S. (2013). Coping styles and illicit drug use in older adults with HIV/AIDS. Psychology of Addictive Behaviors, 27, 1050-1058. doi:10.1037/a0031044.
  • Stone, V.E., Jordan, J., Tolson, J., Miller, R. y Pilon, T. (2004). Perspectives on adherence and simplicity for HIV-infected patients on antiretroviral therapy: self-report of the relative importance of multiple attributes of highly active antiretroviral therapy (HAART) regimens in predicting adherence. Journal of Acquired Immune Deficiency Syndromes, 36, 808-816.
  • Tancredi, M.V. y Waldman, E.A. (2014). Survival of AIDS patients in Sao Paulo-Brazil in the preand post-HAART eras: a cohort study. BMC Infectious Diseases, 14, 599. doi:10.1186/s12879-014-0599-8.
  • Taylor, A.L., Denniston, M.M., Klevens, R.M., McKnight-Eily, L.R. y Jiles, R.B. (2016). Association of Hepatitis C Virus with Alcohol Use Among U.S. Adults: NHANES 2003-2010. American Journal of Preventive Medicine, 51, 206-215. doi:10.1016/j.amepre.2016.02.033.
  • Torrens, M., Mestre-Pintó, J.I., Montanari, L., Vicente, J. y Domingo-Salvany, A. (2017). Dual diagnosis: an European perspective. Adicciones, 29, 3-5. doi:10.20882/adicciones.933.
  • Tripathi, A., Youmans, E., Gibson, J.J. y Duffus, W.A. (2011). The impact of retention in early HIV medical care on viro-immunological parameters and survival: a statewide study. AIDS Research and Human Retroviruses, 27, 751-758. doi:10.1089/AID.2010.0268.
  • Tucker, J.S, Orlando, M., Burnam, M.A., Sherbourne, C.D., Kung, F.Y. y Gifford, A.L. (2004). Psychosocial mediators of antiretroviral nonadherence in HIV-positive adults with substance use and mental health problems. Health Psychology, 23, 363-370. doi:10.1037/0278-6133.23.4.363.
  • Vagenas, P., Azar, M.M., Copenhaver, M.M., Springer, S.A., Molina, P.E. y Altice, F.L. (2015). The impact of alcohol use and related disorders on the HIV continuum of care: a systematic review: alcohol and the HIV continuum of care. Current HIV/AIDS Reports, 12, 421-436. doi:10.1007/s11904-015-0285-5.
  • Van Dorn, R. A., Desmarais, S. L., Swartz, M. S., Young, M. S. y Sellers, B. G. (2014). Letter to the Editor: Critique of Bahorik et al. (2013) -“Under-reporting of drug use among individuals with schizophrenia: prevalence and predictors.” Psychological Medicine, 44, 668–670. doi:10.1017/S0033291713002511.
  • Viswanathan, S., Justice, A.C., Alexander, G.C., Brown, T.T., Gandhi, N.R., McNicholl, I.R., … Jacobson, L.P. (2015). Adherence and HIV RNA Suppression in the Current Era of Highly Active Antiretroviral Therapy. Journal of Acquired Immune Deficiency Syndromes, 69, 493-498. doi:10.1097/QAI.0000000000000643.
  • Williams, E.C., Hahn, J.A., Saitz, R., Bryant, K., Lira, M.C. y Samet, J.H. (2016). Alcohol Use and Human Immunodeficiency Virus (HIV) Infection: Current Knowledge, Implications, and Future Directions. Alcoholism: Clinical and Experimental Research, 40, 2056-2072. doi:10.1111/ acer.13204.
  • Zarkin, G.A., Bray, J.W., Babor, T.F. y Higgins-Biddle, J.C. (2004). Alcohol drinking patterns and health care utilization in a managed care organization. Health Services Research, 39, 553-570. doi:10.1111/j.14756773.2004.00244.x.
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