The international consortium will evaluate the effect of opioid use disorder (OUD) and related medicines on immune recovery triggered by antiretroviral therapy (ART).

HIV infection and also chronic opioid exposure are linked to immune activation that causes depletion of T cells and progression to acquired immunodeficiency syndrome (AIDS).

OUD is often addressed using drugs that activate or block the opioid receptor.

The new research initiative is meant to better understand the role of opioid receptor in the regulation of immune activation and explore the effects of various medications for opioid use disorder (MOUDs) classes, in HIV-infected individuals.

Wistar Vaccine & Immunotherapy Center HIV-1 Immunopathogenesis Laboratory director Herbert Kean said: “We have uncovered a potential link between substance abuse, HIV infection and MOUDs that may determine health outcomes only if the right medication is chosen.

“Yet, we have a very limited understanding of how the medications we use to treat OUD impact disease progression and the response to ART in people living with HIV.”

The funds from the NIDA will be used to support two clinical studies.

One is a three-arm randomised trial to assess the impact of long-term use of MOUDs on immune reconstitution in HIV patients who inject drugs and are initiating ART.

The study will be performed among the US, Vietnam and France. It will track recovery outcomes and therapy adherence at 48 weeks after ART initiation in 225 participants.

During the second trial, mechanistic studies will be conducted on local people with HIV taking ART and also MOUDs.

The trial will investigate the preliminary finding of higher myeloid activation and HIV persistence in people receiving opioid receptor agonists compared with those on opioid receptor antagonist naltrexone.