THE EFFECT OF METHADONE ON IMMUNOLOGICAL PARAMETERS AMONG HIV-POSITIVE AND HIV-NEGATIVE DRUG-USERS

Our objective was to assess the effects of methadone use on immune par ameters. A convenience sample of men and women drug injectors who knew their HIV serostatus were enrolled in a longitudinal observational st udy of HIV illness. During analysis of baseline data, differences were noted in immune parameters among Methadone users. Study participants were recruited in Manhattan, New York, from a methadone maintenance cl inic, an infectious disease clinic of an inner city hospital, and a dr ug-free community center. The participants were 220 men and women, cur rent or former drug injectors, approximately half of them HIV-antibody positive and the rest HN-antibody negative. Candidates with opportuni stic infections and secondary neoplasms were excluded. Methadone users were compared to nonmethadone users for absolute and percentage count s of CD4, CD8, and activated T lymphocytes; CD4/CD8 ratio; an HIV symp tom check list; and medical staging. The results discussed in this pap er were formulated after data collection was complete. Our data indica te that methadone treatment, while not significantly affecting absolut e CD4 lymphocyte count, is associated with a lower CD4 percentage and CD4/CD8 cell ratio, and with a higher CD8 absolute count and percentag e. These differences are present regardless of HIV serostatus. Our fin dings should be interpreted with caution since we did not set out to i nvestigate the effects of methadone on the immune system. Nevertheless , if it is corroborated that methadone has a detrimental effect on the immune system, finding alternatives to methadone-maintenance treatmen t for drug injectors will be a necessity.