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Updated: Dec 7, 2025

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

Livio Azzoni1, David Metzger2, Luis J Montaner3

  • 1HIV Immunopathogenesis Laboratory, The Wistar Institute, 3601 Spruce Street, Philadelphia, PA, 19104, USA.

Journal of Neuroimmune Pharmacology : the Official Journal of the Society on Neuroimmune Pharmacology
|September 25, 2020
PubMed

Insights

Opioid use impacts HIV infection stages and immune responses. Research suggests potential reductions in HIV reservoirs with opioid use disorder treatments, guiding future HIV cure studies.

Area of Science:

  • Immunology
  • Virology
  • Pharmacology

Background:

  • Opioid engagement with Mu opioid receptors influences HIV life cycle stages.
  • The impact of opioid use on HIV latency and viral reservoirs is not fully understood.
  • Increased immune activation in opioid users was hypothesized to enlarge HIV reservoirs, but this is not supported by current data.

Purpose of the Study:

  • To review experimental data linking opioid use to HIV modulation.
  • To explore the scientific basis for differential changes in immune activation and HIV reservoirs with various opioid use disorder medications.
  • To guide future HIV cure-directed research in individuals with HIV and opioid use disorder.

Main Methods:

  • Review of experimental data on opioid use and HIV.
  • Analysis of scientific premises for immune activation and HIV reservoir changes.
  • Consideration of Mu opioid receptor engagement and ART-mediated immune reconstitution.

Main Results:

  • Opioid use affects HIV replication, immune activation, and microbial dysbiosis.
  • Evidence suggests opioid use may lead to lower latent HIV burden.
  • Differential effects on immune activation and HIV reservoirs are expected with different medications for opioid use disorder.

Conclusions:

  • Understanding opioid receptor interactions and ART-mediated immune reconstitution is crucial.
  • Opioid use can impact immune reconstitution outcomes even with viral suppression.
  • Further research is needed to optimize HIV cure strategies for individuals with co-occurring HIV and opioid use disorder.
Keywords:
ART suppressionHIV latent reservoirImmune reconstitutionMedications of opioid use disorderMicrobial translocationOpioid use disorder

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