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AIDS and Behavior

, Volume 19, Issue 6, pp 1089–1097 | Cite as

Heroin Use and HIV Disease Progression: Results from a Pilot Study of a Russian Cohort

  • E. Jennifer EdelmanEmail author
  • Debbie M. Cheng
  • Evgeny M. Krupitsky
  • Carly Bridden
  • Emily Quinn
  • Alexander Y. Walley
  • Dmitry A. Lioznov
  • Elena Blokhina
  • Edwin Zvartau
  • Jeffrey H. Samet
Original Paper

Abstract

Opioids have immunosuppressive properties, yet their impact on HIV disease progression remains unclear. Using longitudinal data from HIV-infected antiretroviral therapy-naïve Russian individuals (n = 77), we conducted a pilot study to estimate the effect of heroin use on HIV disease progression. Heroin use was categorized based on past 30 days self-reported use at baseline, 6 and 12 months as none, intermittent or persistent. We estimated the effect of heroin use on HIV disease progression, measured as change in CD4 count from baseline to 12 months, using multivariable linear regression. Those with intermittent (n = 21) and no heroin use (n = 39) experienced mean decreases in CD4 count from baseline to 12 months (−103 and −10 cells/mm3, respectively; adjusted mean difference (AMD) −93; 95 % CI −245, 58). Those with persistent use (n = 17) showed a mean increase of 53 cells/mm3 (AMD 63; 95 % CI −95, 220). Future studies exploring the effects of heroin withdrawal on HIV disease progression are warranted.

Keywords

Heroin HIV disease progression HIV CD4 

Resumen

Los opioides tienen propiedades inmunosupresoras, pero su impacto sobre la progresión de la enfermedad VIH sigue siendo poco clara. Utilizando datos longitudinales de infectados por el VIH terapia antirretroviral personas rusas (n = 77), se realizó un estudio piloto para estimar el efecto del uso de la heroína sobre la progresión de la enfermedad VIH. Uso de la heroína se clasificó en últimos 30 días auto-informe en el momento de referencia, 6 meses y 12 meses como ninguno, intermitente o persistente. Se estimó el efecto del uso de la heroína sobre la progresión de la enfermedad VIH, medido como cambio de recuento de CD4 en la línea de base para 12 meses, mediante regresión lineal multivariante. Aquellos con intermitente (n = 21) y no uso de la heroína (n = 39) experimentaron disminuciones promedio del número CD4 desde el nivel basal de 12 meses (−103 células/mm3 y 10 células/mm3, respectivamente; diferencia de medias ajustadas (AMD) −93; IC 95 % −245, 58). Las personas con uso persistente (n = 17) mostraron un aumento medio de 53 células/mm3 (AMD 63; IC 95 % −95, 220). Futuros estudios que exploren los efectos de la heroína retirada sobre la progresión de la enfermedad VIH están garantizados.

Notes

Acknowledgments

The project was supported by the National Institute of Drug Abuse (R21 DA025435; R25-DA13582; and K12DA033312-01A1) and the National Institute on Alcohol Abuse and Alcoholism (K24 AA015674; R01 AA016059; U24AA020778; and U24AA020779).

Conflict of interest

The authors have no known conflicts of interest.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • E. Jennifer Edelman
    • 1
    Email author
  • Debbie M. Cheng
    • 2
  • Evgeny M. Krupitsky
    • 3
    • 4
  • Carly Bridden
    • 5
  • Emily Quinn
    • 6
  • Alexander Y. Walley
    • 7
  • Dmitry A. Lioznov
    • 3
  • Elena Blokhina
    • 3
  • Edwin Zvartau
    • 3
  • Jeffrey H. Samet
    • 7
    • 8
  1. 1.Section of General Internal Medicine, Department of MedicineYale University School of MedicineNew HavenUSA
  2. 2.Department of BiostatisticsBoston University School of Public HealthBostonUSA
  3. 3.First St. Petersburg Pavlov State Medical UniversitySt. PetersburgRussian Federation
  4. 4.St. Petersburg Bekhterev Research Psychoneurological InstituteSt. PetersburgRussian Federation
  5. 5.Section of General Internal Medicine, Boston Medical Center, Department of MedicineClinical Addiction Research and Education (CARE) UnitBostonUSA
  6. 6.Department of Biostatistics, Data Coordinating CenterBoston University School of Public HealthBostonUSA
  7. 7.Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of MedicineBoston University School of Medicine/Boston Medical CenterBostonUSA
  8. 8.Department of Community Health SciencesBoston University School of Public HealthBostonUSA

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