Marder K, Liu X, Stern Y, Malouf R, Dooneief G, Bell K, Todak G, Joseph M, Sorrell S, el Sadr W
Gertrude H. Sergievsky Center, New York, NY 10032, USA.
Arch Neurol. 1995 Dec;52(12):1174-82. doi: 10.1001/archneur.1995.00540360052016.
Although the proportion of cases of acquired immunodeficiency syndrome related to intravenous drug use has increased dramatically over the past decade, there has been no longitudinal examination of primary neurologic disease in this group.
To study the development of neurologic disease in human immunodeficiency virus (HIV)-negative and HIV-positive men and women who were intravenous drug users over a 3.5-year period.
Prospective observational cohort study.
Subjects were recruited from an infectious disease clinic at a New York City Hospital or from a methadone maintenance program.
Ninety-nine HIV-negative (62 men and 37 women) and 124 HIV-positive (85 men and 39 women) intravenous drug users volunteered.
The development of clinically significant manifestations in six neurologic domains.
With multivariate adjustment for current and past substance abuse, age, education, and head injury, we examined the odds of developing HIV-related neurologic disease. Extrapyramidal signs and reduced motor ability became increasingly apparent over time in HIV-infected men as their CD4 cell count declined and as the subjects developed the acquired immunodeficiency syndrome. Fewer neurologic signs were seen in the women.
The impact of HIV infection among intravenous drug users parallels that in homosexual men and is independent of alcohol and other drug use.
尽管在过去十年中，与静脉注射毒品相关的获得性免疫缺陷综合征病例比例急剧上升，但尚未对该群体的原发性神经系统疾病进行纵向研究。
研究在3.5年期间，静脉注射毒品的人类免疫缺陷病毒（HIV）阴性和HIV阳性男性及女性的神经系统疾病发展情况。
前瞻性观察队列研究。
受试者从纽约市一家医院的传染病诊所或美沙酮维持治疗项目中招募。
99名HIV阴性（62名男性和37名女性）和124名HIV阳性（85名男性和39名女性）静脉注射毒品使用者自愿参与。
六个神经学领域中具有临床意义的表现的发展情况。
在对当前和过去的药物滥用、年龄、教育程度和头部损伤进行多变量调整后，我们研究了发生HIV相关神经系统疾病的几率。随着HIV感染男性的CD4细胞计数下降以及他们发展为获得性免疫缺陷综合征，锥体外系体征和运动能力下降随着时间的推移变得越来越明显。女性出现的神经学体征较少。
HIV感染对静脉注射毒品使用者的影响与对同性恋男性的影响相似，且与酒精和其他药物使用无关。
