HIV-Positive Illicit Drug Users Have Increased Risk For Opportunistic Infections, Death, Study Says

HIV-positive users of cocaine and heroine have an increased risk for opportunistic infections and death compared with HIV-positive nonusers, according to a study published in the January 4 on-line edition of the American Journal of Epidemiology, Reuters reports. Gregory Lucas of the Johns Hopkins University School of Medicine and colleagues surveyed a total of 1,851 HIV-positive individuals every six months starting in 1998. Researchers grouped the participants into different categories: 1,028 "nonusers"; 588 "intermittent users," who had used illicit drugs an average of 14 days in the last six months; and 235 "persistent users," who had used illicit drugs an average of 27 days in the last six months. After three years, researchers found that the approximate survival rates were 87% for nonusers, 80% for intermittent users and 68% for persistent users. After adjusting for various factors -- including age, race, gender and CD4+ T-cell counts -- researchers found that the risk of death was almost double in intermittent users and almost triple in persistent users. During periods when users abstained from illicit drug use, the risk of opportunistic infections decreased to the level associated with nonusers, according to the study. The observed increase in risk might be attributed to the effect illicit drugs have on the immune system, as well as a lack of access to care or failure to adhere to antiretroviral therapy, the researchers said (Reuters, 3/6). "Effectively targeting and treating active substance abuse in HIV treatment settings may provide a mechanism to improve clinical outcomes," the study says (Lucas et al., American Journal of Epidemiology, 3/1).


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