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Center","award":["AG05064"],"award-info":[{"award-number":["AG05064"]}]},{"name":"HIV Neurobehavioral Research Center","award":["AG065385"],"award-info":[{"award-number":["AG065385"]}]},{"name":"HIV Neurobehavioral Research Center","award":["P30 MH062512"],"award-info":[{"award-number":["P30 MH062512"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Objective: Many persons with opioid use disorders (OUDs) have HIV disease and experience clinically significant stress after they enroll in abstinence-based treatment and undergo medically assisted withdrawal. We examined whether opioid withdrawal affects virologic control, inflammatory markers, cognition, and mood in persons with an OUD and HIV, and explored whether measures of withdrawal stress, such as activation of the HPA axis, contribute to alterations in immune function, cognition, and mood. Method and participants: Study participants were 53 persons with HIV who were admitted for OUD treatment at the City Addiction Hospital in Saint Petersburg, Russian Federation. Participants were examined at admission, at the anticipated peak of withdrawal 3 to 7 days after the last day of a clonidine-based withdrawal process lasting 7 to 14 days, and 3 to 4 weeks after completing withdrawal. At these times, participants received medical exams and were evaluated for symptoms of withdrawal, as well as cognition and mood. Viral load, plasma cortisol, DHEA sulfate ester (DHEA-S), interleukin-6 (IL-6), and soluble CD14 (sCD14) were determined. Multivariable models examined the relationships between markers of HPA activation and the other parameters over time. Results: HPA activation as indexed by cortisol\/DHEA-S ratio increased during withdrawal, as did markers of immune activation, IL-6 and sCD14. There were no significant associations between viral load and indicators of HPA activation. In longitudinal analyses, higher cortisol\/DHEA sulfate was related to worse cognition overall, and more mood disturbance. Increase in IL-6 was associated with worse cognitive performance on a learning task. There were no significant associations with sCD14. Conclusions: Worsening of cognition and measures of mood disturbance during withdrawal were associated with activation of the HPA axis and some measures of inflammation. Whether repeated episodes of opioid withdrawal have a cumulative impact on long-term HIV outcomes and neurocognition is a topic for further investigation.<\/jats:p>","DOI":"10.3390\/v16010092","type":"journal-article","created":{"date-parts":[[2024,1,8]],"date-time":"2024-01-08T07:59:20Z","timestamp":1704700760000},"page":"92","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effects of Opioid Withdrawal on Psychobiology in People Living with HIV"],"prefix":"10.3390","volume":"16","author":[{"given":"Igor","family":"Grant","sequence":"first","affiliation":[{"name":"HIV Neurobehavioral Research Program, Department of Psychiatry, University of California San Diego, San Diego, CA 92103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evgeny","family":"Krupitsky","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Pavlov State Medical University, 197022 Saint Petersburg, Russia"},{"name":"Department of Addictions, Bekhterev National Medical Research Center for Psychiatry and Neurology, 192019 Saint Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Vetrova","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Pavlov State Medical University, 197022 Saint Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anya","family":"Umlauf","sequence":"additional","affiliation":[{"name":"HIV Neurobehavioral Research Program, Department of Psychiatry, University of California San Diego, San Diego, CA 92103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert K.","family":"Heaton","sequence":"additional","affiliation":[{"name":"HIV Neurobehavioral Research Program, Department of Psychiatry, University of California San Diego, San Diego, CA 92103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard L.","family":"Hauger","sequence":"additional","affiliation":[{"name":"HIV Neurobehavioral Research Program, Department of Psychiatry, University of California San Diego, San Diego, CA 92103, USA"},{"name":"Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA"},{"name":"Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA 92093, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Toussova","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Pavlov State Medical University, 197022 Saint Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald R.","family":"Franklin","sequence":"additional","affiliation":[{"name":"HIV Neurobehavioral Research Program, Department of Psychiatry, University of California San Diego, San Diego, CA 92103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott L.","family":"Letendre","sequence":"additional","affiliation":[{"name":"HIV Neurobehavioral Research Program, Department of Psychiatry, University of California San Diego, San Diego, CA 92103, USA"},{"name":"Department of Medicine, University of California, San Diego, CA 92093, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Woody","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Blokhina","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Pavlov State Medical University, 197022 Saint Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3643-7354","authenticated-orcid":false,"given":"Dmitry","family":"Lioznov","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Pavlov State Medical University, 197022 Saint Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3597-7482","authenticated-orcid":false,"given":"Edwin","family":"Zvartau","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Pavlov State Medical University, 197022 Saint Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e1192","DOI":"10.1016\/S2214-109X(17)30375-3","article-title":"Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: A multistage systematic review","volume":"5","author":"Degenhardt","year":"2017","journal-title":"Lancet Glob. 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