Effect of Opioid Use on Immune Activation and HIV Persistence on ART

A Correction to this article was published on 24 October 2020

This article has been updated

Abstract

While there is an emerging consensus that engagement of the Mu opioid receptor by opioids may modulate various stages the HIV life cycle (e.g.: increasing cell susceptibility to infection, promoting viral transcription, and depressing immune responses to virally-infected cells), the overall effect on latency and viral reservoirs remains unclear. Importantly, the hypothesis that the increase in immune activation observed in chronic opioid users by direct or indirect mechanisms (i.e., microbial translocation) would lead to a larger HIV reservoir after ART-suppression has not been supported to date. The potential for a subsequent decrease in reservoirs after ART-suppression has been postulated and is supported by early reports of opioid users having lower latent HIV burden. Here, we review experimental data supporting the link between opioid use and HIV modulation, as well as the scientific premise for expecting differential changes in immune activation and HIV reservoir between different medications for opioid use disorder. A better understanding of potential changes in HIV reservoirs relative to the engagement of the Mu opioid receptor and ART-mediated immune reconstitution will help guide future cure-directed studies in persons living with HIV and opioid use disorder.

Review. HIV replication, immune activation and dysbiosis: opioids may affect immune reconstitution outcomes despite viral suppression

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Change history

  • 24 October 2020

    The original version of this article unfortunately contained mistakes.

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Funding

Funding for this work was provided by grants to LJM (NIH: 1UM1Al126620, R01 DA048728, R01 DA049666), Robert I. Jacobs Fund of the Philadelphia Foundation, the Kean Family Professorship, and the Wistar Institute.

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Azzoni, L., Metzger, D. & Montaner, L.J. Effect of Opioid Use on Immune Activation and HIV Persistence on ART. J Neuroimmune Pharmacol 15, 643–657 (2020). https://doi.org/10.1007/s11481-020-09959-y

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Keywords (4–6)

  • Opioid use disorder
  • Medications of opioid use disorder
  • HIV latent reservoir
  • ART suppression
  • Immune reconstitution
  • Microbial translocation