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

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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.

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.

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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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Authors and Affiliations

  1. Section of General Internal Medicine, Department of Medicine, Yale University School of Medicine, P.O. Box 208025, New Haven, CT, 06520-8088, USA

    E. Jennifer Edelman

  2. Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA

    Debbie M. Cheng

  3. First St. Petersburg Pavlov State Medical University, St. Petersburg, Russian Federation

    Evgeny M. Krupitsky, Dmitry A. Lioznov, Elena Blokhina & Edwin Zvartau

  4. St. Petersburg Bekhterev Research Psychoneurological Institute, St. Petersburg, Russian Federation

    Evgeny M. Krupitsky

  5. Section of General Internal Medicine, Boston Medical Center, Department of Medicine, Clinical Addiction Research and Education (CARE) Unit, Boston, MA, USA

    Carly Bridden

  6. Department of Biostatistics, Data Coordinating Center, Boston University School of Public Health, Boston, MA, USA

    Emily Quinn

  7. Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine/Boston Medical Center, Boston, MA, USA

    Alexander Y. Walley & Jeffrey H. Samet

  8. Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA

    Jeffrey H. Samet

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  1. E. Jennifer Edelman
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Edelman, E.J., Cheng, D.M., Krupitsky, E.M. et al. Heroin Use and HIV Disease Progression: Results from a Pilot Study of a Russian Cohort. AIDS Behav 19, 1089–1097 (2015). https://doi.org/10.1007/s10461-014-0948-z

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