title: Low serum thiol levels predict shorter times-to-death among HIV-infected injecting drug users.
abstract: OBJECTIVE
  To investigate whether serum thiol levels are altered by HIV disease, and whether low serum thiols predict time to death among HIV-infected injecting drug users (IDU).
  
  
  METHODS
  A cross-sectional study of serum thiol levels among 13 HIV-seronegative IDU, 116 HIV-seropositive IDU, and 17 HIV-seropositive IDU with a history of AIDS, and a cohort study of the 133 HIV-infected IDU who took part in the cross-sectional study.
  
  
  METHODS
  Subjects were recruited from a methadone-maintenance treatment program during 1990-1991. Total serum thiols were determined spectrophotometrically at enrolment; low serum thiols were defined as those with an absorbance at 412 nm < or = 0.46. Deaths through 31 December 1993 were determined from the National Death Index (NDI). Twenty-six HIV-seropositive subjects died during follow up; death certificates, which were obtained for 23 subjects, indicated AIDS or HIV infection for 20. Product-limit estimation was used to calculate survival. Multivariate analyses employed Cox proportional-hazards regression.
  
  
  RESULTS
  Analysis of cross-sectional data showed that serum thiols did not differ significantly among HIV-free subjects, HIV-infected subjects, and HIV-infected subjects with a history of AIDS. Cohort analysis, adjusted for age, revealed that persons with those with high serum thiols (relative hazard = 2.83; 95% confidence interval (CI), 1.15, 6.97); a significant interaction between low serum thiols and a history of AIDS was associated with a relative hazard of 5.65 (95% CI, 1.22-2.61).
  
  
  CONCLUSIONS
  Among HIV-infected persons, low serum thiols, especially in concert with a history of AIDS, predict mortality risk. These findings support the hypothesis that oxidative stress is critical to the pathogenesis of HIV infection.
authors.affiliation: Department of Environmental Medicine, New York University School of Medicine, NY 10010-2598, USA.
authors.forename: M
authors.initials: M
authors.lastname: Marmor
authors.forename: P
authors.initials: P
authors.lastname: Alcabes
authors.forename: S
authors.initials: S
authors.lastname: Titus
authors.forename: K
authors.initials: K
authors.lastname: Frenkel
authors.forename: K
authors.initials: K
authors.lastname: Krasinski
authors.forename: A
authors.initials: A
authors.lastname: Penn
authors.forename: R W
authors.initials: RW
authors.lastname: Pero
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000378:metabolism* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015999:Multivariate Analysis; D018384:Oxidative Stress; D011237:Predictive Value of Tests; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000401:mortality / Q000821:virology; D013438:Sulfhydryl Compounds / Q000032:analysis* / Q000097:blood / Q000378:metabolism*; D016019:Survival Analysis
chemical_list: D013438:Sulfhydryl Compounds