Heroin Abuse Aggravates HIV Progression

Even intermittent heroin abuse can worsen human immunodeficiency virus (HIV) infections, according to research published in AIDS and Behavior.

Alongside a team of Russian researchers, investigators from Yale and Boston Universities studied 77 HIV-infected, antiretroviral therapy-naïve individuals in order to determine the effect of heroin use on the infectious disease’s progression. The study authors categorized the subjects’ self-reported heroin use as none, intermittent, or persistent at 30 days past baseline, 6 months, and 12 months, and they measured the effect of heroin use through a multivariable linear regression model based on changes in CD4 count from baseline to 12 months.

Patients who reported intermittent and no heroin use experienced mean decreases in CD4 count of -103 cells/mm³ and -10 cells/mm³, respectively, while persistent heroin users demonstrated a mean increase of 53 cells/mm³, the researchers found.

“We expected that HIV-positive patients who abused heroin on an ongoing basis would have the greatest decreases in their CD4 count, but this preliminary study showed that those who abused heroin intermittently had lower CD4 cell counts, indicating a weakened immune system,” said lead author E. Jennifer Edelman, MD, an assistant professor of medicine at the Yale School of Medicine, in a press release. “Our findings suggest that heroin withdrawal may be particularly harmful to the immune system, as measured by CD4 cell count.”

Prior laboratory and epidemiological studies have concluded that opioids such as heroin are harmful to the immune system, but they have not particularly explored their contribution to HIV disease progression.

“This manuscript represents an important step towards identifying the need for future study of the effects of heroin withdrawal on HIV disease progression, as it may have unique effects compared with chronic and no heroin use,” Dr. Edelman continued.

The researchers concluded that future research examining the effects of heroin withdrawal on HIV progression is needed.