The Potential Role of Buprenorphine in the Treatment of Opioid Dependence in HIV-Infected Individuals and in HIV Infection Prevention

Untreated opioid dependence is a major obstacle to the successful treatment and prevention of human immunodeficiency virus (HIV) infection. In this review, we examine the interwoven epidemics of HIV infection and opioid dependence and the emerging role of buprenorphine in improving HIV treatment out...

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Bibliographic Details
Published in:Clinical infectious diseases 2006-12, Vol.43 (Supplement-4), p.S178-S183
Main Authors: Altice, Frederick L., Sullivan, Lynn E., Smith-Rohrberg, Duncan, Basu, Sanjay, Stancliff, Sharon, Eldred, Lois
Format: Article
Language:English
Subjects:
Addictive behaviors
Adult and adolescent clinical studies
AIDS
Antiretroviral drugs
Biological and medical sciences
Buprenorphine - therapeutic use
Clinical outcomes
Dose-Response Relationship, Drug
Drug addiction
Drug addictions
Drug Administration Schedule
Drug therapy
Epidemics
Female
Follow-Up Studies
Highly active antiretroviral therapy
HIV
HIV infections
HIV Infections - drug therapy
HIV Infections - epidemiology
HIV Infections - prevention & control
Human immunodeficiency virus
Human viral diseases
Humans
Incidence
Infectious diseases
Injections
Male
Medical sciences
Methadone
Narcotic Antagonists - therapeutic use
Opioid analgesics
Opioid-Related Disorders - diagnosis
Opioid-Related Disorders - drug therapy
Opioid-Related Disorders - epidemiology
Physicians
Primary health care
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Risk Assessment
Severity of Illness Index
Substance abuse
Substance Abuse Detection - methods
Substance Abuse Treatment Centers
Survival Analysis
Toxicology
Treatment Outcome
United States - epidemiology
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
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Summary:Untreated opioid dependence is a major obstacle to the successful treatment and prevention of human immunodeficiency virus (HIV) infection. In this review, we examine the interwoven epidemics of HIV infection and opioid dependence and the emerging role of buprenorphine in improving HIV treatment outcomes among infected individuals, as well as its role in primary and secondary prevention. This article addresses some of the emerging issues about integrating buprenorphine treatment into HIV clinical care settings and the various strategies that must be considered. Specifically, it addresses the role of buprenorphine in improving HIV treatment outcomes through engagement in care, access to antiretroviral therapy and preventive therapies for opportunistic infections, and the potential benefits of and pitfalls in integrating buprenorphine into HIV clinical care settings. We discuss the key research questions regarding buprenorphine in the area of improving HIV treatment outcomes and prevention, including a review of published studies of buprenorphine and antiretroviral treatment and currently ongoing studies, and provide insight into and models for integrating buprenorphine into HIV clinical care settings. Dialogue among practitioners and policy makers in the HIV care and substance abuse communities will facilitate an effective expansion of buprenorphine and ensure that these beneficial outcomes are achieved.
ISSN:1058-4838
1537-6591
DOI:10.1086/508181