It has been demonstrated that NTX is effective in reducing the number of drinks and heavy alcohol use days and extends the rates of abstinence [40C42]
It has been demonstrated that NTX is effective in reducing the number of drinks and heavy alcohol use days and extends the rates of abstinence [40C42]. (PLH). In summary, with some anticipations, NTX and XR-NTX administration in individuals living with HIV and AUDs led to reduced alcohol use, improved viral suppression, unchanged ART adherence and has no significant adverse events. Conclusion The findings of this systematic review suggest the beneficial effects and safety of the NTX and XR-NTX for treating AUDs in PLH. Further studies are needed in the future to focus on the treatment of AUDs in people living with HIV. strong class=”kwd-title” Keywords: Alcohol use disorders (AUDs), HIV, Naltrexone, Systematic review, Treatment Intro Alcohol use disorders (AUDs) are a expensive, common and disabling health condition that is considered as probably one of the most severe public health problems [1]. Alcohol use is highly common among positive human being immunodeficiency computer virus (HIV) individuals [2C5]. Alcohol use in people living with HIV/AIDS seems to be 2C4 occasions more prevalent than the general populace [3, 6, 7] and it has also been estimated that about 40C50% of these patients had a history of weighty alcohol use [8, 9]. There are several harmful linkages between alcohol use and HIV. Heavy alcohol use has the ability for interfering with immune system functions [10C12], increasing in the incidence of severe bacterial infections (especially tuberculosis) [13, 14], liver damage and hepatotoxicity in the case of connected illness such as hepatitis C [15], and make changes in the rate of metabolism of antiretroviral medicines [16, 17]. Moreover, weighty alcohol use is linked to the harmful behavior i.e. illicit drug use, smoking, and enhanced unsafe sexual activities. Besides, it has been reported that alcohol use is associated with an increase in the risk of chronic ailments such as cardiovascular disease and malignancy in people living with HIV [18C22]. Alcohol use among people living with HIV affects negatively on their adherence and engagement to the HIV treatment, treatment results and mortality risk [7, 23C25]. There are various pharmacological/behavioral treatments for treating AUDs [26C31]. Pharmacotherapy is recommended for AUD treatment [28, 32], and FDA-approved medications for these disorders include acamprosate, disulfiram, and naltrexone [28, 32]. Besides above-mentioned medicines, strong evidence found concerning the use of topiramate for AUD treatment inside a meta-analysis study [28]. Opioid antagonist, naltrexone (NTX) offered under the brand names Revia and Vivitrol among others, is an important pharmacological medication. Dental and injectable forms of naltrexone are commercially available [26, 33]. It is utilized for controlling of AUDs and it is effective to reduce alcohol use and craving [34C37]. This opioid receptor antagonist has a related structure with morphine and has a high affinity for the – and -opioid receptor active sites [38]. It is believed that NTX may lead to the antagonism of opioid pathways towards nucleus accumbens, and thus reduces the amount of released dopamine [39]. It has been shown that NTX is effective in reducing the number of drinks and weighty alcohol use days and stretches the rates of abstinence [40C42]. The main goal of this research is to provide a systematic review of the current evidence regarding the application of naltrexone for the pharmacotherapy of AUDs in people living with HIV. The impact of oral naltrexone (NTX) and injectable extended-release form (XR-NTX) around the alcohol use and HIV related outcomes are discussed. Methods Searching strategy This study is designed according to the PRISMA statement [43]. A systematic literature search was conducted on the online databases including Google Scholar, Pubmed Medline, Scopus, and the Cochrane Library until June 2019. The key search terms were: (naltrexone and HIV and alcohol) or (naltrexone and HIV and drinking) or (naltrexone and AIDS and alcohol) or (naltrexone and AIDS and drinking) or (Vivitrol and HIV and alcohol) or (Vivitrol and HIV and drinking) or (Vivitrol and AIDS and alcohol) or (Vivitrol and AIDS and alcohol) or (Revia and HIV and.Edelman et al., 2019 reported that for the XR-NTX group, the estimated mean CD4 was lower than the placebo group at baseline VU6005649 and this difference were not statistically-significant ( em p /em ?=?0.75) [45]. VACS index scoreDuring the 24-week treatment period in the study of Edelman et al., 2019, there were no significant differences in the VACS index scores between the groups by condition ( em p /em ?=?0.70), or over time ( em p /em ?=?0.63) [45]. Safety Cook et al., 2017 reported that however, the proportion of those reporting adverse event relating to drug consumption for NTX receiving participants are greater compared to placebo (70% vs. this systematic review, the results of 7 relevant studies including pilot and randomized controlled/clinical trials were summarized and reviewed. Among selected records 2 of these assessed the efficacy of NTX and 5 tested the XR-NTX effectiveness in treating AUDs among persons living with HIV (PLH). In summary, with some expectations, NTX and XR-NTX administration in persons living with HIV and AUDs led to reduced alcohol use, improved viral suppression, unchanged ART adherence and has no significant adverse events. Conclusion The findings of this systematic review suggest the beneficial effects and safety of the NTX and XR-NTX for treating AUDs in PLH. Further studies are needed in the future to focus on the treatment of AUDs in people living with HIV. strong class=”kwd-title” Keywords: Alcohol use disorders (AUDs), HIV, Naltrexone, Systematic review, Treatment Introduction Alcohol use disorders (AUDs) are a costly, common and disabling health condition that is considered as one of the most serious public health problems [1]. Alcohol use is highly prevalent among positive human immunodeficiency virus (HIV) individuals [2C5]. Alcohol use in people living with HIV/AIDS seems to be 2C4 times more prevalent than the general population [3, 6, 7] and it has also been estimated that about 40C50% of these patients had a history of heavy alcohol use VU6005649 [8, 9]. There are several harmful linkages between alcohol use and HIV. Heavy alcohol use has the ability for interfering with immune system functions [10C12], increasing in the incidence of serious bacterial infections (especially tuberculosis) [13, 14], liver damage and hepatotoxicity in the case of associated infection such as hepatitis C [15], and make changes in Rabbit Polyclonal to OR2G2 the metabolism of antiretroviral drugs [16, 17]. Moreover, heavy alcohol use is linked to the harmful behavior i.e. illicit drug use, smoking, and enhanced unsafe sexual activities. Besides, it has been reported that alcohol use is associated with an increase in the risk of chronic illnesses such as cardiovascular disease and cancer in people living with HIV [18C22]. Alcohol use among people living with HIV affects negatively on their adherence and engagement to the HIV treatment, treatment outcomes and mortality risk [7, 23C25]. There are various pharmacological/behavioral treatments for treating AUDs [26C31]. Pharmacotherapy is recommended for AUD treatment [28, 32], and FDA-approved medications for these disorders include acamprosate, disulfiram, and naltrexone [28, 32]. Besides above-mentioned drugs, strong evidence found regarding the use of topiramate for AUD treatment in a meta-analysis study [28]. Opioid antagonist, naltrexone (NTX) sold under the brand names Revia and Vivitrol among others, is an important pharmacological medication. Oral and injectable forms VU6005649 of naltrexone are commercially available [26, 33]. It is used for managing of AUDs and it is effective to reduce alcohol use and craving [34C37]. This opioid receptor antagonist has a comparable structure with morphine and has a high affinity for the – and -opioid receptor active sites [38]. It is believed that NTX may lead to the antagonism of opioid pathways towards the nucleus accumbens, and thus reduces the amount of released dopamine [39]. It has been exhibited that NTX is effective in reducing the number of drinks and weighty alcoholic beverages use times and stretches the prices of abstinence [40C42]. The primary goal of the research is to supply a organized review of the existing evidence regarding the use of naltrexone for the pharmacotherapy of AUDs in people coping with HIV. The effect of dental naltrexone (NTX) and injectable extended-release form (XR-NTX) for the alcoholic beverages make use of and HIV related results are discussed. Strategies Searching technique This research is designed based on the PRISMA declaration [43]. A organized books search was carried out on the web directories including Google Scholar, Pubmed Medline, Scopus, as well as the Cochrane Library until June 2019. The main element search terms had been: (naltrexone and HIV and alcoholic beverages) or (naltrexone and HIV and consuming) or (naltrexone and Helps and alcoholic beverages) or (naltrexone and Helps and consuming) or (Vivitrol and HIV and alcoholic beverages) or (Vivitrol and HIV and consuming) or (Vivitrol and Helps and alcoholic beverages) or (Vivitrol and Helps and alcoholic beverages) or (Revia and HIV and alcoholic beverages) or (Revia and HIV and consuming) or (Revia and Helps and alcoholic beverages) or (Revia and Helps and alcoholic beverages). Addition/exclusion requirements and research selection Only research that check out the effectiveness of NTX or XR-NTX for dealing with AUDs in PLH to become included. Exclusion requirements in this research had been as: 1) Review content articles, pet research and the ones scholarly research that just reported the pharmacology results,.