Trends and predictors in methadone maintenance treatment dropout in Shanghai, China: 2005-2011

Background: The methadone maintenance treatment (MMT) program has been implemented in Shanghai since 2005. This study aims to portray the trend of MMT dropout and identify predictive factors that may influence dropout in Shanghai MMT clinics, which could assist in the intervention strategy development. Methods: A retrospective evaluation was used in the Shanghai component of the National MMT data management system between January 1, 2005 and December 31, 2011. The Cox model for recurrence events was employed to estimate hazard ratio (HR) predicting dropout during the follow-up period. Results: Of all 6169 participants, 63% dropped out of the program at least once (ranging from 0 to 10 times), and 74% of them did not return by the end of this study. The average monthly incidence rate of dropout was 4.4% with a range from 0 to 9.3%. Adjusted analyses demonstrated that the individuals with methadone tapering didn't have a greater probability of dropping out compared to those with stable dosage (HR = 1.07, 95% CI: 0.90-1.27). However, there was a higher dropout rate among younger individuals (= 50 years old; HR = 1.41, 95% CI: 1.16-1.71), among those who were less educated (HR = 1.48, 95% CI: 1.17-1.87), among those who shared needles with others (HR = 1.29, 95% CI: 1.06-1.58), among those whose urine tested positive for opiates (HR = 1.69, 95% CI: 1.51-1.89), and among those who had a low average methadone dose at the initial stable stage of treatment (65 mg/day; HR = 1.39, 95% CI: 1.19-1.63). Conclusions: Shanghai has been facing the challenge of keeping a high MMT retention rate. Increasing the use of methadone tapering after a stable treatment stage with sufficient dosage could be attempted in the MMT program, as well as considering comprehensive interventions among specific populations, such as young, poorly educated, opiate-positive and needle sharing individuals

Additional file 1: Figure S1. of Integrin-β5, a miR-185-targeted gene, promotes hepatocellular carcinoma tumorigenesis by regulating β-catenin stability

MHCC-97 L cell lysates were incubated with IgG (control) or ITGB5 antibody. The bounded proteins were eluted, resolved by SDS-PAGE, and visualized by CBB staining (upper panel). The band in the ITGB5 lane was identified as β-catenin by mass spectrometry. The obtained peptide sequences by mass spectrometry analysis were shown on the right.(B-D)The RNA levels of miR-185 were analysed by q-RT-PCR. (TIFF 552 kb

Factors associated with HIV Seroconversions in 12-month follow-up study among YMSM in Cox regression analysis.

<p>*Denotes significance at <i>P</i><0.10 level.</p>a<p>Dichotomous variables: Age: 0 = 21∼25 years, 1 = 18∼20 years; Married: 0 = no, 1 = yes; Local resident: 0 = yes, 1 = no; Student: 0 = yes, 1 = no; Homosexual: 0 = yes, 1 = no; HIV/AIDS knowledge: 0 = know, 1 = unacquaintance (know: scores of HIV/AIDS knowledge = 6–8, unacquaintance: scores of HIV/AIDS knowledge = 0–5); Had anal sex with men: 0 = no, 1 = yes; Male sexual partners for more than 2: 0 = no, 1 = yes; Consistent condom use with male sex partners: 0 = yes, 1 = no; Being paid by a man for sex: 0 = no, 1 = yes; Consistent condom use when paid for sex: 0 = no, 1 = yes; Had specific symptoms of STD infections in the past 12 months: 0 = no, 1 = yes; Syphilis infection: 0 = no, 1 = yes.</p

Sociodemographic characteristics associated with HIV incidence of YMSM cohort participants.

<p>Sociodemographic characteristics associated with HIV incidence of YMSM cohort participants.</p

Socio-demographic Characteristics of YMSM cohort participants in Baseline and Follow-up.

<p>Socio-demographic Characteristics of YMSM cohort participants in Baseline and Follow-up.</p

The levels of CD4+T cell count in Shanghai young MSM infected with HIV-1 CRF01_AE, CRF07_BC, and subtype B.

<p>The statistical significance in levels of CD4+T cell count (Median and Interquartile Range [IQR]) among three different subtypes and recombinants, CRF01_AE, CRF07_BC, and subtype B was calculated using the Two Independent Samples Nonparametric Tests (Man-Whitney U).</p

Demographics and Clinical Characteristics Based on Co-receptor Tropism.

<p>*Algorithm I: Geno2pheno (FPR = 10%) and webPSSM in combination;</p><p>**Algorithm II: Geno2pheno (FPR = 5%) and webPSSM in combination.</p

Phylogenetic tree analysis based on HIV-1 <i>pol</i> region among MSM who were newly infected from 2009 to 2013 in Shanghai.

<p>The phylogenetic trees were constructed using the Neighbor-Joining method. The bootstrap values of 1000 replicates above 70% are marked on the cluster nodes. CRF01_AE sequence cluster is shown as a triangle in red, CRF07_BC cluster in blue, subtype B cluster in green, and CRF55_01B cluster in pink. U, ambiguous/unidentified subtypes or recombinants and is marked as a solid circle in black. The reference sequences obtained from the Los Alamos HIV database are marked as a solid triangle in black. Trees were rooted by group O. The pie figures presented the proportion of analyzed subtypes represented in the corresponding phylogenetic trees.</p

Socio-demographic Characteristics of Studied Subjects Based on Subtypes.

<p>*The year when blood samples were collected.</p><p>**Place of birth. North: Beijing, Hebei, Shanxi and Inner Mongolia; Northeast: Liaoning, Jilin, and Heilongjiang; East: Fujian, Shandong, Zhejiang, Anhui, JiangXi, and Jiangsu; South Central: Guangxi, Henan, Hubei, Hunan, Guangdong and Hainan; Southwest: Sichuan, Chongqing, Guizhou and Ynunan; Northwest: Shannxi, Gansu, Ningxia, Qinghai and Xinjiang.</p

Phylogenetic tree analysis of HIV-1 <i>env</i> and <i>pol</i> gene sequences among MSM with recent infections in Shanghai.

<p>The phylogenetic trees were constructed using neighbor-joining methods (Mega 5.0) based on <i>pol</i> (A) and <i>env</i> (B) sequence regions. The bootstrap values of 1000 replicates above 75% are labeled on the major clusters nodes. The CXCR4-tropic strains determined with algorithm I were indicated by both solid and open circles, whereas the CXCR4-tropic strains determined with algorithm II were only indicated by solid circles. CRF01_AE sequences are marked in red, CFR07_BC sequences are marked in green, and subtype B/B’ sequences are marked in blue. U stands for unidentified subtypes/recombinants. The subtype reference sequences from the Los Alamos HIV sequence database (<a href="http://hiv-web.lanl.gov/content/index" target="_blank">http://hiv-web.lanl.gov/content/index</a>) were indicated by solid triangles. Trees were rooted using group O as a out group.</p