Nutrition issues in the HIV-infected injection drug user: findings from the nutrition for healthy living cohort.
OBJECTIVE
The purpose of this paper is to highlight disparities between injection drug users (IDUs) and those who had never been IDUs from the Nutrition for Healthy Living (NFHL) cohort. Although IDUs were enrolled in the cohort throughout its duration, few analyses have sought to highlight findings specific to them.


METHODS
NFHL, a prospective, longitudinal cohort conducted from 1995-2005, included 881 human immunodeficiency virus (HIV) -infected men and women over the age of 18. Subjects were seen every 6 months; body composition and dietary and laboratory data were collected. Individuals were classified as current IDUs, past IDUs, and never-IDUs. The classification of ever-IDU combined current and past users.


RESULTS
In NFHL, a higher proportion of ever-IDUs were women, African American, had a high school education or less, smoked, and were housing insecure and food insecure compared to never-IDUs. Ever-IDUs had lower total, soluble, and insoluble fiber and individual micronutrient intakes. A higher proportion of ever-IDUs had hepatitis C and HIV-related symptoms, used highly active antiretroviral therapy (HAART) less, and had a CD4 count <500 cells/mm3, than never-IDUs, at the study endpoint.


CONCLUSIONS
The course of HIV infection in past and current IDUs appears to be unique and requires more investigation. Physiologic and sociodemographic characteristics of IDUs contribute to poor disease management and nutritional status. Classic manifestations of HIV persist in IDUs in the HAART era.
Hendricks
Kristy M
KM
Hood Center for Children and Families, Dartmouth Medical School, One Medical Center Drive, HB 7465, Lebanon, NH 03756, USA. kristy.m.hendricks@dartmouth.edu
Erzen
Heather D
HD
Wanke
Christine A
CA
Tang
Alice M
AM
D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D015704:CD4 Antigens; D015331:Cohort Studies; D004043:Dietary Fiber / Q000008:administration & dosage*; D055030:Drug Users; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D006526:Hepatitis C / Q000150:complications* / Q000276:immunology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage*; D008875:Middle Aged; D015596:Nutrition Assessment; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000276:immunology
D044966:Anti-Retroviral Agents; D015704:CD4 Antigens; D004043:Dietary Fiber; D018977:Micronutrients