HIV And HCV infection among opiate-dependent patients and methadone doses: the PROTEUS study

Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) are prevalent infections in opiate-dependent patients. Opiate replacement treatment (ORT) with methadone or buprenorphine is associated with several important outcomes among patients with opiate dependence. However, little is known about outcomes in patients with HIV and/or HCV infections that are in ORT. Also, it is not well established whether the presence of HCV or HIV infection could be associated with higher methadone doses. This paper reanalyzes the database of PROTEUS study, using two principal variables: methadone dose and presence of HIV and/or HCV infection. PROTEUS recruited 621 patients (84.1% were male, mean age: 38.9 years, SD: 7.9), information about the presence of HIV in status was available for 390 patients. Of those, 134 (34.4%) were HIV-infected. Whilst, information about HCV infection was available for 377 patients. Of those, 315 (83.6%) were HCV-infected. Information on HIV/HCV coinfection was available for 376 patients, of those, 112 (29.8%) had this coinfection. HIV-infected and HIV/HCV-coinfected patients received higher methadone doses than those without these infections. Antiretroviral therapy (ART) was used in 80% of patients with HIV infection. The proportion of patients taking antiretroviral drugs was significantly higher for patients treated with higher methadone doses (p < 0.01). Findings suggest that HIV-infected and HIV/HVC-coinfected patients in ORT require higher methadone dose.