Overamped: Stimulant Use and HIV Pathogenesis

Purpose of Review In the era of HIV treatment as prevention (TasP), more clarity is needed regarding whether people with HIV who use stimulants (i.e., methamphetamine, powder cocaine, and crack cocaine) display elevated HIV viral load and greater immune dysregulation. Recent Findings Although rates...

Full description

Saved in:
Bibliographic Details
Published in:Current HIV/AIDS reports 2023-12, Vol.20 (6), p.321-332
Main Authors: Ross, Emily J., Williams, Renessa S., Viamonte, Michael, Reynolds, John M., Duncan, Dustin T., Paul, Robert H., Carrico, Adam W.
Format: Article
Language:English
Subjects:
Acquired Immunodeficiency Syndrome - drug therapy
Biomarkers
Cell-mediated immunity
Central Nervous System Stimulants - adverse effects
Cocaine
Crack Cocaine - adverse effects
HIV
HIV Infections - pathology
Human immunodeficiency virus
Humans
Medicine
Medicine & Public Health
Methamphetamine
Methamphetamine - adverse effects
Microbiomes
Pathogenesis
Stimulants
Topical Collection on Behavioral-Bio-Medical Interface
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose of Review In the era of HIV treatment as prevention (TasP), more clarity is needed regarding whether people with HIV who use stimulants (i.e., methamphetamine, powder cocaine, and crack cocaine) display elevated HIV viral load and greater immune dysregulation. Recent Findings Although rates of viral suppression have improved in the TasP era, stimulant use was independently associated with elevated viral load in 23 of 28 studies included in our review. In the 12 studies examining other HIV disease markers, there was preliminary evidence for stimulant-associated alterations in gut-immune dysfunction and cellular immunity despite effective HIV treatment. Studies generally focused on documenting the direct associations of stimulant use with biomarkers of HIV pathogenesis without placing these in the context of social determinants of health. Summary Stimulant use is a key barrier to optimizing the effectiveness of TasP. Elucidating the microbiome-gut-brain axis pathways whereby stimulants alter neuroimmune functioning could identify viable targets for pharmacotherapies for stimulant use disorders. Examining interpersonal, neighborhood, and structural determinants that could modify the associations of stimulant use with biomarkers of HIV pathogenesis is critical to guiding the development of comprehensive, multi-level interventions.
ISSN:1548-3568
1548-3576
DOI:10.1007/s11904-023-00672-y