Medications for Treatment of Opioid Use Disorder among Persons Living with HIV
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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.
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.
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.
KeywordsExtended-release naltrexone Methadone Buprenorphine HIV Opioid use disorders MAT Medication for opioid use disorder Opioid addiction
US National Institutes of Health, National Institute on Drug Abuse (Korthuis: UG1DA015815, UG3DA044831, R01DA037441; Springer: K02DA032322).
Compliance with Ethical Standards
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.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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