Journal of Urban Health

, Volume 76, Issue 4, pp 468–480 | Cite as

Evaluating supervised haart in late-stage HIV among drug users: A preliminary report

  • Barbara Greenberg
  • Alan Berkman
  • Rogelio Thomas
  • David Hoos
  • Ruth Finkelstein
  • Jacquie Astemborski
  • David Vlahov
Original Articles

Abstract

Objective

To examine response to highly active antiretroviral therapy (HAART) among a sample of treatment-experienced patients in the late stage of human immunodeficiency virus (HIV) infection in residential health care facilities (RHCFs) in New York City facilities designated for HIV/AIDS (acquired immunodeficiency syndrome) when access and adherence are maximized.

Methods

Medical record review of 111 patients.

Results

Demographics were mean age 42 years; 58% male; 60% African-American; 31% Hispanic; 57% injection drug users (IDUs); 23% with history of dementia; 52% hepatitis C virus (HCV) antibody seropositive; 80% on HAART, of whom 18% had lipodystrophy. Of 88 patients on HAART, 52% had a decreased viral load (>1/2log) versus 13% of 23 not on HAART (P<.05); a>1/2log viral load increase was seen in 8% and 35%, respectively (P<.05). Those with viral load increase were more likely than those with stable/decreased viral load to be IDUs (71% vs. 64%) and to have HCV seropositivity (86% vs. 53%), even with similar initial CD4+ cell count, viral load, and follow-up time.

Conclusion

In a predominantly minority IDU population who are treatment experienced, 50% of the patients successfully responded to treatment with supervised therapy. The RHCFs in New York City provide a unique opportunity to examine further factors associated with response to HAART in an environment in which medication administration and adherence are maximized and monitored carefully.

Key Words

Advanced HIV HAART Hepatitis C Seropositivity IDUs Residential Health Care Facilities Substance Abuse Viral Load 

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Copyright information

© The New York Academy of Medicine 1999

Authors and Affiliations

  • Barbara Greenberg
    • 1
  • Alan Berkman
    • 2
  • Rogelio Thomas
    • 2
  • David Hoos
    • 3
  • Ruth Finkelstein
    • 1
  • Jacquie Astemborski
    • 1
  • David Vlahov
    • 1
  1. 1.Office of Special Populations/Center for Urban Epidemiologic StudiesNew York Academy of MedicineNew York
  2. 2.Bronx-Lebanon Special Care CenterBronx-LebanonUSA
  3. 3.AIDS InstituteNew York State Department of HealthUSA

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