title: Clinical implications of addiction related immunosuppression.
abstract: OBJECTIVE
  Despite increasing evidence suggesting that drug addicts have compromised immunity, vigorous discussion continues. One way to examine this clinically is to compare the rates of infections presenting to a clinic which sees both non-substance dependent (N-SUD) and opiate addicted (SUD) patients.
  
  
  METHODS
  A survey was conducted amongst our patients of all infectious presentations.
  
  
  RESULTS
  Four-hundred and thirty SUD and 116 N-SUD patients of similar ages (mean+/-SD 30.81+/-7.77 years vs. 32.91+/-14.41 respectively) were reviewed. SUD had fewer acute infections (120/430, 28% vs. 51/116 44%, OR=0.60 95% CI 0.40-0.84, P=0.0034) but their severity was greater (P<0.00001). The pattern of infections was also different with respiratory infections predominating in N-SUD (32/50 infections, 64%; seasonally invariant) vs. dental (74/114, 64%) and skin infections (18/114, 16%) in SUD. SUD had significantly more dental infections (74/430 patients 21% vs. 3/116 3%, P=0.0001). In multivariate analysis, group membership was the only variable which explained the variance of "Infection". Chronic hepatitis C (60% vs. 1%, P<0.00001) was more frequent in the SUD but there was no difference in hepatitis B or HIV.
  
  
  CONCLUSIONS
  These data are consistent with clinical immunosuppression in SUD and may reflect immunostimulation and immunosenescence.
authors.affiliation: Southcity Family Medical Centre, 39 Gladstone Road, Highgate Hill, Brisbane, Queensland, 4101, Australia. sreece@bigpond.net.au
authors.forename: Albert Stuart
authors.initials: AS
authors.lastname: Reece
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007108:Immune Tolerance / Q000187:drug effects / Q000502:physiology*; D016867:Immunocompromised Host; D007223:Infant; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000150:complications*; D011793:Queensland / Q000453:epidemiology; D012307:Risk Factors