New evidence to reconcile in vitro and epidemiologic data on the possible role of heroin on CD4+ decline among HIV-infected injecting drug users

Long-term effects of drug type and other drug use related risk factors on C D4 + cell decline were assessed in 224 HIV-infected injecting drug users (I DUs) from Baltimore (ALIVE), USA, and 63 IDUs from Amsterdam, The Netherlan ds. Higher frequencies of borrowing used injection equipment since 1980 res ulted in a higher CD4+ count already present before seroconversion (P = 0.0 49). Use of mainly heroin in the seroconversion interval resulted in a shar per CD4 + decline until the first 6 months after seroconversion (P = 0.004) , but CD4 + values converged later on. This finding might reconcile earlier discordant epidemiological and laboratory study results regarding the poss ible effects of heroin. (C) 1999 Elsevier Science Ireland Ltd. All rights r eserved.