Changing profiles of injecting drug users with AIDS in a Hispanic population.

AIMS: To describe and assess the changing trends in socio-demographic, risk, clinical and immunological parameters in male intravenous drug users (IDU) with AIDS. DESIGN, SETTING AND PARTICIPANTS: Baseline description by year of entry of 610 male IDU with AIDS who entered into a cohort study in Bayamón, Puerto Rico, from 1992 to 2000. Study participants were evaluated at in-patient health-care facilities in the University Hospital Ramón Ruiz Arnau or in the ambulatory immunology clinic facilities. FINDINGS: The median age at which subjects entered the study and the proportion of patients with an educational level lower than a high school degree increased from 1992 to 2000. Upward trends were also observed in the practice of injecting non-prescription drugs during the last 12-month period, the practice of needle sharing and the use of a combination of heroin and cocaine ('speedballs'). Higher proportions of subjects were also diagnosed with wasting syndrome and bacterial pneumonia. The median CD4 count recorded at entry decreased over the course of the study. CONCLUSIONS: Puerto Rican male IDU diagnosed with AIDS are arriving at health-care facilities in the latest stages of the disease. Better and early interventions with different health care approaches need to be developed.

Distribution of naïve (CD45RA+) and memory (CD45RO+) T-cells in HIV-infected Puerto Rican population.

HIV infection usually results in a gradual deterioration of the immune system. It is evident that early recognition of progression markers during HIV infection from asymptomatic to symptomatic state is needed. In the present cross-sectional study, peripheral blood lymphocytes from 63 HIV-infected Puerto Rican individuals were analyzed by two-color flow cytometry to study the co-expression CD45RA and CD45RO on both CD4+ and CD8+ T-cells and its correlation with age, gender, CD4 count, CD4:CD8 ratio, anti-retroviral therapy, clinical status, and viral load. Measurement of T-cell subsets in these patients showed an excessive increase of CD3+CD8+, CD8+CD45RA+, and CD8+CD45RO+ T-cells as disease progresses. In contrast, it was also observed a significant decrease in CD3+CD4+, CD4+CD45RA+ and CD4+CD45RO+ T-cells. The distribution of CD8+CD45RA+ T-cells did not change significantly between HIV and AIDS cases suggesting that this T-cell subset is not a good progression marker. Interestingly, CD4+CD45RA+ T-cells were significantly difference between genders, and CD44+CD45RA+ and CD8+CD45RO+ T-cells were influenced by age. In conclusion, the distribution of naïve/memory CD4+ T-cells and memory CD8+ T-cells significantly correlate with HIV infection in disease progression. It is also important to mention that these T-cell subpopulations may be influenced by both gender and age. Overall, these results suggest that a loss in the generation of new immune response and function may be occurring during disease progression. This study open new windows of understanding that will be beneficial for future studies on immunopathogenesis, diagnosis, prognosis, and treatment monitoring for HIV/AIDS.

Distribution of naïve (CD45RA+) and memory (CD45RO+) T-cells in HIV-infected Puerto Rican population

HIV infection usually results in a gradual deterioration of the immune system. It is evident that early recognition of progression markers during HIV infection from asymptomatic to symptomatic state is needed. In the present cross-sectional study, peripheral blood lymphocytes from 63 HIV-infected Puerto Rican individuals were analyzed by two-color flow cytometry to study the co-expression CD45RA and CD45RO on both CD4+ and CD8+ T-cells and its correlation with age, gender, CD4 count, CD4:CD8 ratio, anti-retroviral therapy, clinical status, and viral load. Measurement of T-cell subsets in these patients showed an excessive increase of CD3+CD8+, CD8+CD45RA+, and CD8+CD45RO+ T-cells as disease progresses. In contrast, it was also observed a significant decrease in CD3+CD4+, CD4+CD45RA+ and CD4+CD45RO+ T-cells. The distribution of CD8+CD45RA+ T-cells did not change significantly between HIV and AIDS cases suggesting that this T-cell subset is not a good progression marker. Interestingly, CD4+CD45RA+ T-cells were significantly difference between genders, and CD44+CD45RA+ and CD8+CD45RO+ T-cells were influenced by age. In conclusion, the distribution of naïve/memory CD4+ T-cells and memory CD8+ T-cells significantly correlate with HIV infection in disease progression. It is also important to mention that these T-cell subpopulations may be influenced by both gender and age. Overall, these results suggest that a loss in the generation of new immune response and function may be occurring during disease progression. This study open new windows of understanding that will be beneficial for future studies on immunopathogenesis, diagnosis, prognosis, and treatment monitoring for HIV/AIDS.