Comorbidities, medications up likelihood of starting chronic opioid therapy in PLHIVs

Among people living with HIV (PLHIVs) who have initiated combination antiretroviral therapy (cART), comorbidities and polypharmacy increase the risk of chronic opioid therapy (COT), a recent study has found.

Researchers conducted a retrospective analysis of 9,615 patients with HIV (mean age 41.0±10.2 years, 46.4 percent women), of whom 1,014 eventually initiated COT over a median follow-up of 2.15 years. COT initiators were older and had more baseline comorbidities than comparators who did not start chronic treatment.

Generalized estimating equation models identified several comorbidities that increased the risk of COT. Among these were any malignancy (odds ratio [OR], 1.28, 95 percent confidence interval [CI], 1.23–1.33), hepatitis C infection (OR, 1.55, 95 percent CI, 1.47–1.64), and substance use disorder (OR, 1.62, 95 percent CI, 1.25–2.12).

Back pain (OR, 1.46, 95 percent CI, 1.10–1.93), arthritis (OR, 1.13, 95 percent CI, 1.01–1.25), and neuropathy pain (OR, 1.17, 95 percent CI, 1.05–1.30) had similar effects.

Medications also increased the risk of COT. For example, taking 1–4 (OR, 1.34, 95 percent CI, 1.29–1.40) and ≥5 (OR, 1.71, 95 percent CI, 1.40–2.09) medications exacerbated the likelihood of initiating COT, as opposed to taking no medication.

The use of benzodiazepines (OR, 1.62, 95 percent CI, 1.48–1.77), gabapentinoids (OR, 1.33, 95 percent CI, 1.21–1.45), antidepressants (OR, 1.31, 95 percent CI, 1.10–1.56), and any opioid (OR, 1,86, 95 percent CI, 1.61–2.13) also increased COT risk.