HIV Management

With the hypothesis that heroin use contributes to a faster spread of the HIV cells in an infected person’s body, researchers out of Yale University conducted a study to look at the link between opiate use and HIV. They teamed up with scientists from Boston University and in Russia, studying participants’ CD4 count to determine their results. These results were quite different than they imagined, as the participants who claimed heavy heroin abuse had higher levels of CD4 than those who claimed only intermittent usage. With this information, the team has concluded that heroin withdrawal quickens the spread of HIV in an infected person’s body, as opposed to a steady use of the narcotic. CD4, which refers to a cluster of differentiation 4, is a specific form of protein that is typically found on immune system cells such as T helper cells and macrophages. This combination of the protein and immune cell, commonly known as white blood cells, are necessary for a healthy immune system to work properly, or at all. Because of this, the amount of CD4 protein found in a person’s body is a good indicator of how well their immune system is working, as lower amounts of these CD4 cells means a weaker or compromised immune system. Fewer CD4 cells in an HIV infected person’s body means the virus has destroyed more of the T helper cells where this glycoprotein is found.

Using this method of determining how much HIV has spread throughout an infected person’s body, the international research team looked at seventy seven participants, all from Russia, all heavy alcohol consumers, and none whom were then on antiretroviral medication. Those who self-reported no usage of heroin had a standard depletion rate of CD4 cells. This came as no surprise to the teams. What was surprising was the fact that those who reported heavy opiate usage had a slower rate of CD4 depletion than those who only occasionally used the drug. This ruled out the notion that heroin speeds up the spread of HIV cells in an infected person’s body, and opened new questions to the teams. Their conclusion is that it isn’t heroin use that speeds up the replication process of HIV – as previously believed – but that heroin withdrawal is the factor that quickens the spread of HIV. Though they cannot yet determine why this is, they do know that heroin withdrawal is one of the worst known to mankind, and like alcohol and benzodiazepines it is one of the only three categories of withdrawals which can actually kill a person. Jennifer Elelman, the lead author of the study and assistant professor at Yale School of Medicine, said, “We expected that HIV-positive patients who abused heroin on an ongoing basis would have the greatest decreases in their CD4 count,” adding that the international research team is now looking at the withdrawal process in relation to the spread of HIV. Not to leave all of their previous assumptions behind as they look at this process, Dr. Edelman continued, “We will also evaluate the effects of heroin and other opioids on other aspects of immune function.”