How Does Heroin Use Impact HIV Infection

Study suggests drug has negative impact on immune system.

HIV-positive patients who occasionally use heroin may exacerbate their condition more so than infected patients who use the drug persistently or not at all.

In a study published recently in the journal AIDS and Behavior, researchers examined how heroin use can affect the CD4 count of infected patients, which has a direct impact on the strength of the immune system.

"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," lead author E. Jennifer Edelman, MD, said in a press release. "Our findings suggest that heroin withdrawal may be particularly harmful to the immune system, as measured by CD4 cell count."

With prior studies showing that opioids are harmful to the immune system, the researchers sought to examine how the progression of HIV disease is impacted by heroin use. The researchers measured CD4 cell counts in 77 HIV-infected patients who are heavy alcohol drinkers not yet on antiretroviral medication.

Patients self-reported use of heroin and other substances at baseline, at 6 months, and at 12 months. The researchers analyzed CD4 count at the start and at the end of a year.

The results showed that patients who occasionally use heroin had lower CD4 counts than patients who abuse the drug consistently.

"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 said. "Our future analyses will include examining other markers of T cell (CD4 and CD8 cell) dysfunction. We will also evaluate the effects of heroin and other opioids on other aspects of immune function."