为艾滋病毒感染者开具阿片类激动剂疗法处方时的注意事项。

IF 3.6 3区 医学 Q2 PHARMACOLOGY & PHARMACY Expert Review of Clinical Pharmacology Pub Date : 2024-07-01 Epub Date: 2024-07-04 DOI:10.1080/17512433.2024.2375448
Adati Tarfa, Audun J Lier, Sheela V Shenoi, Sandra A Springer
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引用次数: 0

摘要

导言:治疗阿片类药物使用障碍(MOUD)的药物包括阿片类药物激动剂疗法(OAT)(丁丙诺啡和美沙酮)和阿片类药物拮抗剂(缓释纳曲酮)。所有形式的 MOUD 都能改善阿片类药物使用障碍(OUD)和艾滋病的治疗效果。然而,针对艾滋病毒和阿片类药物使用障碍的整合服务仍然不足。在获得 MOUD 方面持续存在的障碍凸显了在治疗艾滋病病毒感染者(PWH)的 OUD 时解决药物公平性问题的紧迫性:在这篇综述文章中,我们特别关注艾滋病感染者中的 OAT,因为它是最常用的 MOUD 形式。具体而言,我们描述了艾滋病和 OUD 服务的交叉点,强调通过提供全面的艾滋病和 OUD 筛查、检测和治疗,将其纳入美国遏制艾滋病流行(EHE)计划。我们确定了 OAT 与抗逆转录病毒疗法(ART)之间潜在的药物相互作用,解决了 OAT 获取方面的差异,并介绍了丁丙诺啡长效制剂、抗逆转录病毒疗法和暴露前预防对改善 HIV 预防和治疗以及 OUD 管理的实际益处:专家意见:要优化公共卫生机构的 OUD 治疗效果,就必须认真关注 OUD 的诊断、OUD 治疗的启动以及药物的保留。创新的医疗保健服务方式(如流动药房)可以将 OUD 和 HIV 治疗结合起来,并惠及服务不足的人群。
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Considerations when prescribing opioid agonist therapies for people living with HIV.

Introduction: Medications for opioid use disorder (MOUD) include opioid agonist therapies (OAT) (buprenorphine and methadone), and opioid antagonists (extended-release naltrexone). All forms of MOUD improve opioid use disorder (OUD) and HIV outcomes. However, the integration of services for HIV and OUD remains inadequate. Persistent barriers to accessing MOUD underscore the immediate necessity of addressing pharmacoequity in the treatment of OUD in persons with HIV (PWH).

Areas covered: In this review article, we specifically focus on OAT among PWH, as it is the most commonly utilized form of MOUD. Specifically, we delineate the intersection of HIV and OUD services, emphasizing their integration into the United States Ending the HIV Epidemic (EHE) plan by offering comprehensive screening, testing, and treatment for both HIV and OUD. We identify potential drug interactions of OAT with antiretroviral therapy (ART), address disparities in OAT access, and present the practical benefits of long-acting formulations of buprenorphine, ART, and pre-exposure prophylaxis for improving HIV prevention and treatment and OUD management.

Expert opinion: Optimizing OUD outcomes in PWH necessitates careful attention to diagnosing OUD, initiating OUD treatment, and ensuring medication retention. Innovative approaches to healthcare delivery, such as mobile pharmacies, can integrate both OUD and HIV and reach underserved populations.

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来源期刊
Expert Review of Clinical Pharmacology
Expert Review of Clinical Pharmacology PHARMACOLOGY & PHARMACY-
CiteScore
7.30
自引率
2.30%
发文量
127
期刊介绍: Advances in drug development technologies are yielding innovative new therapies, from potentially lifesaving medicines to lifestyle products. In recent years, however, the cost of developing new drugs has soared, and concerns over drug resistance and pharmacoeconomics have come to the fore. Adverse reactions experienced at the clinical trial level serve as a constant reminder of the importance of rigorous safety and toxicity testing. Furthermore the advent of pharmacogenomics and ‘individualized’ approaches to therapy will demand a fresh approach to drug evaluation and healthcare delivery. Clinical Pharmacology provides an essential role in integrating the expertise of all of the specialists and players who are active in meeting such challenges in modern biomedical practice.
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