RESUMO
We evaluated the associations of specific recreational drugs and alcohol with laboratory predictors of AIDS at entry into the San Francisco Men's Health Study (SFMHS) in 1984 and with the development of the acquired immunodeficiency syndrome (AIDS) during 6 years of follow-up. Marijuana use was associated with a decreased rate of progression to AIDS in the univariate analysis (RR = 0.7; P = 0.01). Marijuana use was more common among individuals with elevated HIV viral core protein antibody (p24Ab) titer (> 1:16) at baseline (P = 0.03); this finding suggests that marijuana users were healthier at baseline. When the data were adjusted for p24 Ab and other laboratory parameters, no association with progression to AIDS was observed for marijuana, suggesting that the observed univariate result was due to a difference in HIV-related disease at the time of enrollment. No statistically significant associations were observed for nitrites, methylene dioxyamphetamines, ethyl chloride, downers, cocaine, stimulants, narcotics, or psychedelic drugs. These data suggest no substantial association between use of these drugs and the development of AIDS among HIV-infected men.
Assuntos
Síndrome da Imunodeficiência Adquirida/epidemiologia , Soropositividade para HIV/epidemiologia , Homossexualidade Masculina/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Síndrome da Imunodeficiência Adquirida/imunologia , Adulto , Distribuição de Qui-Quadrado , Estudos de Coortes , Intervalos de Confiança , Progressão da Doença , Seguimentos , Indicadores Básicos de Saúde , Humanos , Drogas Ilícitas/efeitos adversos , Masculino , Fumar Maconha/efeitos adversos , Fumar Maconha/epidemiologia , Pessoa de Meia-Idade , Razão de Chances , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , São Francisco/epidemiologiaRESUMO
A high percentage of HIV-1-infected infants and children in Romania are coinfected with hepatitis B virus. Little information is available on the impact of concurrent hepatitis B infection on the course of HIV-1 infection. We conducted a prospective cohort study over 1 year in a group of 68 HIV-1-infected infants and children to determine whether hepatitis B surface antigenemia, neopterin, and beta 2-microglobulin (B2M) predicted death. Among the 44 hepatitis B surface antigen-positive (HBsAg+) subjects at enrollment, 13 (30%) died during 1 year of follow-up. In comparison, two of 24 (8%) HBsAg-negative subjects died (RR = 7.7; p = 0.05). Higher initial serum concentrations of neopterin and B2M were negatively associated with survival. After stratifying by baseline clinical evidence of HIV-related disease, survival was negatively associated with HBsAg+ status (p = 0.04) in 33 children in stage P-2, adjusting for age, serum neopterin, and serum B2M levels. The results of this study suggest that serum neopterin is a marker for severity of clinical illness and that HBsAg+ status increases the mortality rate among children with clinical evidence of HIV infection.
Assuntos
Biopterinas/análogos & derivados , Infecções por HIV/mortalidade , HIV-1 , Antígenos de Superfície da Hepatite B/sangue , Microglobulina beta-2/análise , Biopterinas/sangue , Proteínas Sanguíneas/análise , Pré-Escolar , Estudos de Coortes , Atestado de Óbito , Seguimentos , Infecções por HIV/sangue , Infecções por HIV/complicações , Hepatite B/complicações , Humanos , Lactente , Análise Multivariada , Neopterina , Modelos de Riscos Proporcionais , Estudos Prospectivos , Romênia/epidemiologia , Análise de SobrevidaRESUMO
This study evaluated the effect of continued heroin use during methadone treatment on serum neopterin levels in 40 human immunodeficiency virus (HIV) type 1 seropositive (HIV+) and 70 seronegative (HIV-) intravenous drug users (IVDUs). Persistent drug use, determined by urinary evidence of opiates, was more common in HIV+ than in HIV- IVDUs (p = 0.01). Serum neopterin concentration, an indicator of increased probability of progression to AIDS, was elevated in HIV+ IVDUs, p < 0.0001 (mean 16.0 nmol/L) compared to that of HIV- IVDUs (mean 10.0 nmol/L) and in persistent IV drug users compared with abstainers, p < 0.0001. The effect of drug use and HIV status on serum neopterin was not explained by differences in methadone treatment, age, sex, or total years of i.v. drug use. Neopterin decreased in 25 IVDUs, regardless of HIV serostatus, treated with methadone for an average of 1.5 years.