International Journal of STD & AIDS > Volume 20, Number 6 > Pp. 418-422

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Original research articles

Correlates of HIV-1 viral suppression in a cohort of HIV-positive drug users receiving antiretroviral therapy in Hanoi, Vietnam

M R Jordan MD MPH ^*  , H La PhD , H D Nguyen MD , H Sheehan MA MS , T T M Lien MD , D V Duong MD , J Hellinger MD ^*, C Wanke MD ^*  and A M Tang PhD 

^* Tufts Medical Center, Division of Geographic Medicine and Infectious Disease, Boston, MA; Department of Public Health and Family Medicine, Tufts University School of Medicine, Boston, MA, USA; National Institute of Infectious and Tropical Diseases, Hanoi, Vietnam

Correspondence to: Dr M R Jordan, Division of Geographic Medicine and Infectious Disease, Tufts Medical Center, Tufts University School of Medicine, 750 Washington Street, Box 041, Boston, MA 02111, USA Email: mjordan{at}tuftsmedicalcenter.org

Injection drug users bear the burden of HIV in Vietnam and are a focus of national treatment programmes. To date, determinants of successful therapy in this population are unknown. Substance use and clinical correlates of viral suppression were studied in 100 HIV-1-infected drug users receiving antiretroviral therapy (ART) for at least six months in Hanoi, Vietnam. The mean age of the cohort was 29.9 + 4.9 years; all were men. A majority of patients (73%) achieved viral suppression (HIV-RNA <1000 copies/mL). Correlates of viral suppression include self-reported 95% adherence (P < 0.01) and current use of trimethoprim/sulphamethoxazole (P < 0.01); current or ever diagnosed with tuberculosis was associated with viral non-suppression (P = 0.006). Tobacco use was prevalent (84%), and surprisingly 48% of patients reported active drug use; neither was associated with viral non-suppression. This is the first study to document successful ART treatment in a population of Vietnamese drug users; rates of viral suppression are comparable to other international populations. The 28% of patients without HIV-1 suppression highlight the need for adherence promotion, risk reduction programmes, and population-based surveillance strategies for assessing the emergence of HIV drug resistance in settings where access to viral load and drug resistance testing is limited.

Key Words: HIV • Vietnam • antiretroviral therapy • substance abuse • adherence

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