title: Heroin Use and HIV Disease Progression: Results from a Pilot Study of a Russian Cohort.
abstract: Opioids have immunosuppressive properties, yet their impact on HIV disease progression remains unclear. Using longitudinal data from HIV-infected antiretroviral therapy-naïve Russian individuals (n = 77), we conducted a pilot study to estimate the effect of heroin use on HIV disease progression. Heroin use was categorized based on past 30 days self-reported use at baseline, 6 and 12 months as none, intermittent or persistent. We estimated the effect of heroin use on HIV disease progression, measured as change in CD4 count from baseline to 12 months, using multivariable linear regression. Those with intermittent (n = 21) and no heroin use (n = 39) experienced mean decreases in CD4 count from baseline to 12 months (-103 and -10 cells/mm(3), respectively; adjusted mean difference (AMD) -93; 95 % CI -245, 58). Those with persistent use (n = 17) showed a mean increase of 53 cells/mm(3) (AMD 63; 95 % CI -95, 220). Future studies exploring the effects of heroin withdrawal on HIV disease progression are warranted.
authors.affiliation: Section of General Internal Medicine, Department of Medicine, Yale University School of Medicine, P.O. Box 208025, New Haven, CT, 06520-8088, USA, ejennifer.edelman@yale.edu.
authors.forename: E Jennifer
authors.initials: EJ
authors.lastname: Edelman
authors.forename: Debbie M
authors.initials: DM
authors.lastname: Cheng
authors.forename: Evgeny M
authors.initials: EM
authors.lastname: Krupitsky
authors.forename: Carly
authors.initials: C
authors.lastname: Bridden
authors.forename: Emily
authors.initials: E
authors.lastname: Quinn
authors.forename: Alexander Y
authors.initials: AY
authors.lastname: Walley
authors.forename: Dmitry A
authors.initials: DA
authors.lastname: Lioznov
authors.forename: Elena
authors.initials: E
authors.lastname: Blokhina
authors.forename: Edwin
authors.initials: E
authors.lastname: Zvartau
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Samet
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count / Q000706:statistics & numerical data*; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D006556:Heroin Dependence / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D010865:Pilot Projects; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012426:Russia / Q000453:epidemiology; D012959:Socioeconomic Factors; D019562:Viral Load / Q000187:drug effects*
chemical_list: D019380:Anti-HIV Agents