Study on the blood-borne virus co-infection and T lymphocyte subset among intravenous drug users.
OBJECTIVE
To investigate the features of various blood-borne virus infections and co-infection in intravenous drug users (IDUs), and to examine the correlation of T lymphocyte subsets with virus co-infection.


METHODS
Four hundred and six IDUs without any clinical manifestation of hepatitis and 102 healthy persons were enrolled in this study. HBV-DNA and HCV-RNA were detected by fluorescence quantitative PCR. HBsAg, HBeAg, anti-HBc, anti-HCV, HDV-Ag, anti-HGV, anti-HIV, and HCMV-IgM were assayed by enzyme-linked immunosorbent assay (ELISA) and immunochromatographic tests. The levels of Th1 and Th2 cytokines were measured by ELISA and radioactive immune assay (RIA). The T lymphocyte subpopulation was detected by using fluorescence immunoassay. The similar indices taken from the healthy persons served as controls.


RESULTS
The viral infection rate among IDUs was 36.45% for HBV, 69.7% for HCV, 47.3% for HIV, 2.22% for HDV, 1.97% for HGV, and 3.45% for HCMV. The co-infection rate of blood-borne virus was detected in 255 of 406 (62.81%) IDUs. More than 80% (161/192) of subjects infected with HIV were co-infected with the other viruses, such as HBV, HCV. In contrast, among the controls, the infection rate was 17.65% for HBV and 0% for the other viruses. Our investigation showed that there was a profound decrease in the proportion of CD4/CD8 and the percentage of CD3 and CD4, but not in the percentage of CD8. The levels of PHA-induced cytokines (IFN-gamma and IL-4) and serum IL-2 were obviously decreased in IDUs. On the other hand, the level of serum IL-4 was increased. The level of IFN-gamma and the percentage of CD4 were continuously decreased when the IDUs were infected with HIV or HIV co-infection. IDUs with HIV and HBV co-infection was 15.1% (29/192). Of those 29 IDU with HIV and HBV co-infection, 51.72% (15/29) and 37.93% (11/29) were HBV-DNA-positive and HBeAg-positive, respectively. But, among IDUs without HIV infection, only 1.68% (2/119) of cases were HBV-DNA-positive.


CONCLUSIONS
HCV, HBV and HIV infections are common in this population of IDU, leading to a high incidence of impaired Th1 cytokine levels and CD4 lymphocyte. IDUs with HIV and HBV/HCV co-infection have lower expression of Th1 cytokine with enhancement of the Th2 response. HIV may be causing HBV replication by decreasing Th1 function.
Li
Jian-Rong
JR
Department of Pathogenic Biology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China. jrli@mails.tjmu.edu.cn
Gong
Rui-Yu
RY
Tian
Kun-Lun
KL
Wang
Jing
J
Wang
Yi-Xin
YX
Huang
Han-Ju
HJ
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D015496:CD4-Positive T-Lymphocytes / Q000473:pathology; D016022:Case-Control Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D018178:Flaviviridae Infections / Q000097:blood / Q000150:complications* / Q000276:immunology; D029407:GB virus C / Q000235:genetics / Q000276:immunology; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000276:immunology; D015497:HIV-1 / Q000235:genetics / Q000276:immunology; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006509:Hepatitis B / Q000097:blood / Q000150:complications* / Q000276:immunology; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology; D006526:Hepatitis C / Q000097:blood / Q000150:complications* / Q000276:immunology; D006525:Hepatitis, Viral, Human / Q000097:blood / Q000150:complications* / Q000276:immunology; D006801:Humans; D007376:Interleukin-2 / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis; D015819:Substance Abuse, Intravenous / Q000097:blood / Q000150:complications* / Q000276:immunology; D016176:T-Lymphocyte Subsets
D000914:Antibodies, Viral; D004279:DNA, Viral; D007376:Interleukin-2; D012367:RNA, Viral; D015847:Interleukin-4