Beyond the Syndemic of Opioid Use Disorders and HIV: The Impact of Opioids on Viral Reservoirs

• Published in: Viruses Vol. 15; no. 8; p. 1712
• Main Authors: Trunfio, Mattia, Chaillon, Antoine, Beliakova-Bethell, Nadejda, Deiss, Robert, Letendre, Scott L, Riggs, Patricia K, Higgins, Niamh, Gianella, Sara
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.08.2023; MDPI
• Subjects: Acquired immune deficiency syndrome; AIDS; Analgesics, Opioid - pharmacology; Analgesics, Opioid - therapeutic use; Chronic pain; Complications and side effects; Confounding (Statistics); Drug abuse; Drug addiction; Drug dosages; Drug overdose; Fentanyl; Genomes; Health aspects; Heroin; HIV; HIV infection; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Immune system; Infectivity; Latency; Methadone; MicroRNAs; Morphine; Narcotics; Opioid receptors; opioid use disorders; Opioid-Related Disorders; opioids; Pathogenesis; replication; Research Design; reservoir; Review; Syndemic; Virus latency; United States; replication; immune system; reservoir; HIV; opioid use disorders; opioids
• ISSN: 1999-4915; 1999-4915
• DOI: 10.3390/v15081712

People with HIV are more likely to have opioid use disorder and to be prescribed opioids for chronic pain than the general population; however, the effects of opioids on the immune system and HIV persistence have not been fully elucidated. Opioids may affect HIV reservoirs during their establishment, maintenance, and reactivation by enhancing HIV infectivity and replication due to upregulation of co-receptors and impairment of innate antiviral responses. Opioids may also modulate immune cell functioning and microbial translocation and can reverse viral latency. In this review, we summarize the current findings for and against the modulating effects of opioids on HIV cellular and anatomical reservoirs, highlighting the current limitations that affect in vitro, ex vivo, and in vivo studies in the field. We propose further research targets and potential strategies to approach this topic.