title: New evidence to reconcile in vitro and epidemiologic data on the possible role of heroin on CD4+ decline among HIV-infected injecting drug users.
abstract: Long-term effects of drug type and other drug use related risk factors on CD4+ cell decline were assessed in 224 HIV-infected injecting drug users (IDUs) from Baltimore (ALIVE), USA, and 63 IDUs from Amsterdam, The Netherlands. Higher frequencies of borrowing used injection equipment since 1980 resulted in a higher CD4+ count already present before seroconversion (P = 0.049). Use of mainly heroin in the seroconversion interval resulted in a sharper CD4+ decline until the first 6 months after seroconversion (P = 0.004), but CD4+ values converged later on. This finding might reconcile earlier discordant epidemiological and laboratory study results regarding the possible effects of heroin.
authors.affiliation: Division of Public Health and Environment, Municipal Health Service, Amsterdam, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Krol
authors.forename: C
authors.initials: C
authors.lastname: Flynn
authors.forename: D
authors.initials: D
authors.lastname: Vlahov
authors.forename: F
authors.initials: F
authors.lastname: Miedema
authors.forename: R A
authors.initials: RA
authors.lastname: Coutinho
authors.forename: E J
authors.initials: EJ
authors.lastname: van Ameijden
mesh_terms: D000328:Adult; D015142:Baltimore / Q000453:epidemiology; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects*; D003042:Cocaine / Q000009:adverse effects; D015331:Cohort Studies; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000276:immunology*; D003932:Heroin / Q000009:adverse effects; D006801:Humans; D007121:Immunocompetence / Q000187:drug effects; D016014:Linear Models; D018655:Lymphocyte Count / Q000187:drug effects; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000276:immunology*
chemical_list: D003932:Heroin; D003042:Cocaine