In the Journals

CD4 counts lower in occasional heroin users with HIV

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December 19, 2014

Occasional heroin use, as opposed to persistent or no use, could lead to lower CD4 counts in people with HIV, according to recent data.

“This manuscript represents an important step toward 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,” E. Jennifer Edelman, MD, of Yale School of Medicine, said in a press release.

Researchers examined 77 HIV patients already enrolled within the HERMITAGE trial. Participants were at-risk heavy drinkers who were not enrolled in ART and reported unsafe behavior during the 6 months before the study. Participants’ substance use was self-reported at 6 and 12 month follow-ups as either no use (n=39), intermittent use (n=21) or persistent use (n=17). Change between baseline and 12 month CD4 counts was the primary endpoint.

The greatest change during the study period was seen in intermittent heroin users with a mean decrease in CD4 count of –103 cells/mm3. A smaller mean decrease of –10 cells/mm3 was seen in those who reported no heroin use, while those who reported consistent use had a mean increase of 53 cells/mm3.

“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,” Edelman said in the release. “Our findings suggest that heroin withdrawal may be particularly harmful to the immune system, as measured by CD4 cell count.”

Disclosure: The researchers report no relevant financial disclosures.

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