Carballo-Diéguez A, Sahs J, Goetz R, el Sadr W, Sorell S, Gorman J
HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York.
Am J Drug Alcohol Abuse. 1994 Aug;20(3):317-29. doi: 10.3109/00952999409106017.
Our objective was to assess the effects of methadone use on immune parameters. A convenience sample of men and women drug injectors who knew their HIV serostatus were enrolled in a longitudinal observational study of HIV illness. During analysis of baseline data, differences were noted in immune parameters among Methadone users. Study participants were recruited in Manhattan, New York, from a methadone maintenance clinic, and infectious disease clinic of an inner city hospital, and a drug-free community center. The participants were 220 men and women, current or former drug injectors, approximately half of them HIV-antibody positive and the rest HIV-antibody negative. Candidates with opportunistic infections and secondary neoplasms were excluded. Methadone users were compared to nonmethadone users for absolute and percentage counts of CD4, CD8, and activated T lymphocytes; CD4/CD8 ratio; an HIV symptom check list; and medical staging. The results discussed in this paper were formulated after data collection was complete. Our data indicate that methadone treatment, while not significantly affecting absolute CD4 lymphocyte count, is associated with a lower CD4 percentage and CD4/CD8 cell ratio, and with a higher CD8 absolute count and percentage. These differences are present regardless of HIV serostatus. Our findings should be interpreted with caution since we did not set out to investigate the effects of methadone on the immune system. Nevertheless, if it is corroborated that methadone has a detrimental effect on the immune system, finding alternatives to methadone-maintenance treatment for drug injectors will be a necessity.
我们的目标是评估美沙酮使用对免疫参数的影响。对知晓自身HIV血清学状态的男女药物注射者进行了一项便利抽样，纳入了一项关于HIV疾病的纵向观察性研究。在分析基线数据时，注意到美沙酮使用者的免疫参数存在差异。研究参与者从纽约曼哈顿的一家美沙酮维持诊所、一家市中心医院的传染病诊所和一个无毒品社区中心招募。参与者为220名男女，目前或曾经的药物注射者，其中约一半为HIV抗体阳性，其余为HIV抗体阴性。排除有机会性感染和继发性肿瘤的候选人。将美沙酮使用者与非美沙酮使用者在CD4、CD8和活化T淋巴细胞的绝对计数和百分比计数、CD4/CD8比值、一份HIV症状检查表以及医学分期方面进行比较。本文所讨论的结果是在数据收集完成后得出的。我们的数据表明，美沙酮治疗虽然对CD4淋巴细胞绝对计数没有显著影响，但与较低的CD4百分比和CD4/CD8细胞比值相关，并且与较高的CD8绝对计数和百分比相关。无论HIV血清学状态如何，这些差异都存在。由于我们并非旨在研究美沙酮对免疫系统的影响，因此对我们的研究结果应谨慎解读。然而，如果证实美沙酮对免疫系统有不利影响，那么为药物注射者寻找美沙酮维持治疗的替代方法将是必要的。
