RESEARCH ARTICLE


Active Methamphetamine Use is Associated with Transmitted Drug Resis-tance to Non-Nucleoside Reverse Transcriptase Inhibitors in Individuals with HIV Infection of Unknown Duration



Edward R Cachay1, *, Niousha Moini1, Sergei L Kosakovsky Pond1, Rick Pesano2, Yolanda S Lie2, Heidi Aiem1, David M Butler1, Scott Letendre1, Wm. Christopher Mathews1, Davey M Smith1, 3
1 University of California, San Diego, La Jolla, California, USA
2 Monogram Biosciences, Inc., South San Francisco, California, USA
3 Veterans Administration San Diego Healthcare System, San Diego, California, USA


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2007 Bentham Science Publishers Ltd.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/), which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to this author at the University of California, San Diego Medical Center, 200 West Arbor Drive, San Diego, CA 92103-8681, USA; Tel: (619) 543-3939; Fax: (619) 543-7841; E-mail: ecachay@ucsd.edu


Abstract

Background:

Frequent methamphetamine use among recently HIV infected individuals is associated with transmitted drug resistance (TDR) to non-nucleoside reverse transcriptase inhibitors (NNRTI); however, the reversion time of TDR to drug susceptible HIV may exceed 3 years. We assessed whether recreational substance use is associated with detectable TDR among individuals newly diagnosed with HIV infection of unknown duration.

Design:

Cross-sectional analysis.

Methods:

Subjects were enrolled at the University California, San Diego Early Intervention Program. Demographic, clinical and substance use data were collected using structured interviews. Genotypic resistance testing was performed using GeneSeq™, Monogram Biosciences. We analyzed the association between substance use and TDR using bivariate analyses and the corresponding transmission networks using phylogenetic models.

Results:

Between April 2004 and July 2006, 115 individuals with genotype data were enrolled. The prevalence of alcohol, marijuana and methamphetamine use were 98%, 71% and 64% respectively. Only active methamphetamine use in the 30 days prior to HIV diagnosis was independently associated with TDR to NNRTI (OR: 6.6; p=0.002).

Conclusion:

Despite not knowing the duration of their HIV infection, individuals reporting active methamphetamine use in the 30 days prior to HIV diagnosis are at an increased risk of having HIV strains that are resistant to NNRTI.

Keywords: HIV, NNRTI, transmitted drug resistance, methamphetamine..