Correlates of Immune Activation Marker Changes in Human Immunodeficiency Virus (HIV)–Seropositive and High‐Risk HIV‐Seronegative Women Who Use Illicit Drugs

Abstract

The majority of natural history studies of human immunodeficiency virus (HIV) infection have immune and viral parameters in men. Data demonstrating that women have lower HIV-1 RNA levels than men at the same CD4 cell counts have raised the question of immunologic differences in HIV-seropositive women. This study describes levels and changes in phenotypic markers of immune maturity, function, and activation in the CD4 and CD8 cell subsets in HIV-seropositive and high-risk HIV-seronegative women. Our primary hypothesis was that activation levels would be significantly higher among illicit drug users. However, results showed that HIV-1 RNA level was the strongest predictor of marker level and that both HIV-1 RNA level and CD4 cell count were independently associated with CD4 activation, but illicit drug use was not. In summary, this study demonstrated that immune activation was a significant pathogenic feature in women and that activation was driven by HIV infection and not illicit drug use.

HIV-1 in genital tract and plasma of women: Compartmentalization of viral sequences, coreceptor usage, and glycosylation

“…This report complements a larger WIHS study (20), which found that immune activation was driven by HIV-1 infection, and not by illicit drug use. Conditions affecting HIV-1 replication in local compartments such as cell type, cytokine profile, or inflammation, may indeed exert selective pressures leading to compartmentalization, and additional in vivo analyses are needed (13,14).…”

“…We studied 12 participants in the BronxManhattan and Brooklyn, New York sites of the Women's Interagency HIV Study (WIHS), a multicenter, prospective study of HIV-1 infection of women (15,20). Participants were interviewed and examined semiannually; blood and gynecologic specimens including cervicovaginal lavage (CVL) were collected.…”

“…Seeking women with a spectrum of HIV-1 risks and disease, we selected them from a WIHS substudy of illicit drug use and HIV-1 infection (20). We classified participants according to the following three patterns of drug use reported by the women at WIHS visits one and two: (i) Group I.…”

Relationship Between Complementary/Alternative Treatment Use and Illicit Drug Use Among a Cohort of Women with, or at Risk for, HIV Infection

“…Thus, previous WIHS research has shown that self-reported medication use is consistent with objective measures of HIV outcome, such as CD4þ T-cell count, HIV viral load, and self-reported physical functioning, 36 and that self-reported substance use has a high degree of validity using a toxicology analysis for cocaine and opiates on a subset of WIHS participants. 37 Also, participants used a variety of CAM modalities with low frequency of specific modalities. By combining CAM modalities into CAM categories, some of the specificity that specific modalities might have allowed were lost.…”

The Women's Interagency HIV Study: an Observational Cohort Brings Clinical Sciences to the Bench

“…These studies could not have been done in the context of the controlled regimens and adherence requirements necessary for clinical trials. Collaborative work on coinfections such as hepatitis C (3) and human papillomavirus (21,23,18) in the HIV-positive cohort; on the risk of developing other comorbidities related to HIV and antiretroviral therapies, such as cancer (12), diabetes (13), and lipodystrophy (22); and on IVDU (17) and changes in sexual risk behaviors (24) have benefited largely by having a control group of HIVnegative women who match the infected cohort in sociodemographic and behavioral characteristics as well as by having both groups of HIV-positive women: those treated with HAART and those who are HAART naïve.…”