Buprenorphine therapy for opioid use disorder (OUD) is associated with a decline in viral load among people living with HIV, Infectious Diseases Advisor reports.

Jongyeon Kim, of Johns Hopkins Bloomberg School of Public Health, presented findings at the 2020 Conference on Retroviruses and Opportunistic Infections in Boston last month from a study of 207 people with HIV in the Johns Hopkins Hospital HIV Clinic Cohort who began buprenorphine treatment between 2002 and 2018.

Sixty-nine percent of the participants were men, and 88% were Black. The median age was 49 years old.

The study permitted in its analysis data from multiple episodes of buprenorphine use, defined as a participant using the treatment continuously, with a gap of no more 29 days. The majority of the participants had just one treatment episode.

The median viral load one year before participants started buprenorphine was 80, and the median viral load one year after they started the therapy was 50.

To determine the median viral load decline after one year, the investigators broke down their analysis according to the 25th, 50th and 75th percentiles of the initial pretreatment viral load levels.

At the 25th percentile, the median viral load did not change. Viral load declined by a median of 44 at the 50th percentile and by 4,360 at the 75th percentile.

Before buprenorphine treatment, 69% of the participants’ viral loads were below 1,500, which researchers consider indicative of nontransmissible virus. After treatment, 74% of the participants’ viral loads were below this cutoff.

“These data suggest that buprenorphine treatment for OUD among people with HIV is likely to have beneficial effects on HIV RNA,” the researchers concluded. “By increasing the proportion of people with HIV below 1,500 copies per milliliter, it would lower the overall risk for HIV transmission.”

To read the Infectious Disease Advisor article, click here.

To read the conference abstract, click here.