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Medications for Treatment of Opioid Use Disorder among Persons Living with HIV

  • Behavioral Bio-Medical Interface (JL Brown and RJ DiClemente, Section Editors)
  • Published:
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Abstract

Purpose of Review

Recent HIV outbreaks have occurred as a result of the current US opioid epidemic. Providing medications for opioid use disorder (MOUD) with methadone, buprenorphine, and extended-release naltrexone is essential to achieving optimal HIV treatment outcomes including viral suppression and retention in treatment. This review describes the pharmacology of MOUD with specific attention to interactions with antiretroviral therapy, and to the effect of MOUD on HIV treatment outcomes.

Recent Findings

Methadone and buprenorphine both improve HIV viral suppression, adherence to antiretroviral therapy, and overall mortality for persons with opioid use disorder (OUD). Extended-release naltrexone has been most extensively studied in persons with HIV leaving incarcerated settings, and improves HIV viral suppression in that context.

Summary

Strategies that integrate MOUD and HIV treatment are crucial to optimize viral suppression. The differing pharmacokinetic and delivery characteristics of these MOUD offer diverse options. Given the chronic and relapsing nature of both HIV and OUD, long-term approaches are required.

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Funding

US National Institutes of Health, National Institute on Drug Abuse (Korthuis: UG1DA015815, UG3DA044831, R01DA037441; Springer: K02DA032322).

Author information

Authors and Affiliations

  1. Division of Infectious Disease, University of Kentucky College of Medicine, 740 South Limestone, K512, Lexington, KY, 40536, USA

    Laura Fanucchi

  2. Center on Drug and Alcohol Research, University of Kentucky College of Medicine, Lexington, KY, USA

    Laura Fanucchi

  3. Department of Internal Medicine, Section of Infectious Disease, Yale School of Medicine, New Haven, CT, USA

    Sandra A. Springer

  4. Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, USA

    Sandra A. Springer

  5. Section of Addiction Medicine, Oregon Health & Science University, Portland, OR, USA

    P. Todd Korthuis

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  1. Laura Fanucchi
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Correspondence to Laura Fanucchi.

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Conflict of Interest

Dr. Korthuis serves as principal investigator for NIH-funded clinical trials that receive donated study medication from Alkermes (extended-release naltrexone) and Inidivior (buprenorphine/naloxone). Dr. Fanucchi has nothing to disclose.

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Fanucchi, L., Springer, S.A. & Korthuis, P.T. Medications for Treatment of Opioid Use Disorder among Persons Living with HIV. Curr HIV/AIDS Rep 16, 1–6 (2019). https://doi.org/10.1007/s11904-019-00436-7

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