SED, Istituto Super iore di Sanitá, Rome, Italy.
Addict Biol. 1999 Apr;4(2):197-202. doi: 10.1080/13556219971704.
The role of continued drug use in development of AIDS has been investigated, using mainly CD4(+) cells as outcome variable. The objective of this study was to verify whether continued drug use can influence HIV-1 plasma viral load.We used cross-sectional enrolment data of the HIV-infected IDUs cohort study Manif 2000 (October 1995-October 1996), recruiting patients in hospital departments of Marseilles, Nice and Paris suburbs. To minimize biases due to differential access to health care, only patients receiving outpatient care for at least 2 years but with no antiretroviral treatment were selected for analysis (n = 108). Available information regarding clinical and laboratory information from medical records and clinical examination as well as drug use and HIV-related risk practices were obtained by a face-to-face and a self-administered questionnaire. Patients denying recent heroin injection were cross-validated by a serological assay to detect morphine. Forty-two patients (39%) reported recent heroin injection; among those denying recent use (n=66), eight (positive for serum morphine assay) were re-classified as IDUs. A difference of 0.35 log in viral load was observed between active and ex-IDUs which increases (0.6 log, p=0.03) in those who have been using drugs for 10 years or more.This result persisted when adjusted for CD4(+) counts, clinical stage or years since diagnosis. Continued drug use may have a significant but limited impact on HIV viral load only in patients with a longer history of drug use. Consequences of persisting drug use on long-term progression to AIDS has to be investigated further.
本研究旨在验证是否持续使用毒品会影响 HIV-1 血浆病毒载量。我们使用了 1995 年 10 月至 1996 年 10 月间马赛、尼斯和巴黎郊区医院部门 HIV 感染 IDU 队列研究 Manif 2000 的横断面入组数据，招募患者。为了最大程度地减少因获得医疗保健机会不同而导致的偏倚，仅选择了至少接受 2 年门诊治疗但未接受抗逆转录病毒治疗的患者进行分析（n = 108）。通过面对面和自我管理问卷获得了来自病历和临床检查的临床和实验室信息以及药物使用和 HIV 相关风险行为的可用信息。否认最近注射海洛因的患者通过检测吗啡的血清学检测进行交叉验证。42 名患者（39%）报告最近注射过海洛因；在否认最近使用的患者中（n=66），有 8 名（血清吗啡检测呈阳性）被重新归类为 IDU。在过去 10 年或更长时间持续使用毒品的患者中，观察到病毒载量差异为 0.35 对数，这一差异增加了（0.6 对数，p=0.03）。在调整了 CD4(+)计数、临床分期或诊断后，该结果仍然存在。持续使用毒品可能对 HIV 病毒载量有显著但有限的影响，仅限于有较长毒品使用史的患者。需要进一步研究持续使用毒品对艾滋病长期进展的后果。
