Effects of Mu-opiate receptor engagement on the persistence of HIV-associated activation and viral reservoirs in individuals receiving medication assisted treatment for opioid use disorder

Both HIV infection and exposure to opioids, including intravenous heroin in people who inject drugs (PWIDs), are associated with systemic immune activation due to, at least partially, dysbiosis and increased microbial translocation from the gut. Medication-assisted treatment (MAT) approaches based on the administration of Opioid Receptor (MOR) agonists (e.g. methadone) are clinically effective in terms of harm reduction, but may also contribute to sustained immune activation, limiting the positive immunological outcomes of ART in HIV-infected PWIDs. The primary objective of this proposal is to conduct a clinical study to establish whether chronic engagement of mu-opioid receptor (MOR) by full (methadone) or partial (buprenorphine + naloxone) agonists is a major factor in sustaining bacterial translocation and immune activation modulating in ART suppressed individuals with opioid use disorder (OUD) receiving MAT, resulting in A) increased microbial translocation; B) sustained innate and adaptive immune activation and inflammation in blood or GALT; and C) higher levels of HIV persistence on ART (i.e., integrated HIV DNA, cell-associated HIV RNA) when compared to a full MOR antagonist (XR-NTX).

You may be eligible for this study if you meet the following criteria:

• Conditions: Medical Research
• Age: 99 years or below
• Gender: All