CURRENT MANAGEMENT OF INFECTIOUS COMPLICATIONS IN THE INJECTING DRUG-USER

The diagnosis and management of infectious complications associated wi th injection drug use (IDU) are among some of the more challenging asp ects of working with substance abusing populations. As the population of injection drug users age, we expect the number and severity of thes e complications to increase. Commonly seen infections, such as bacteri al endocarditis and bacterial infections of bones, joints, and soft ti ssue, are now frequently complicated by concurrent immunodeficiency. P arenterally and sexually transmitted viral hepatitis is responsible fo r significant IDU morbidity and mortality. The human leukemia/lymphoma virus types I and II are increasing in prevalence in the IDU with unc ertain long-term clinical effects. Immune dysfunction has been describ ed in the IDU for decades, but the impact of host immune compromise on the transmission and the course of HIV-1 has yet to be fully apprecia ted. The integration of the treatment of substance abuse and its concu rrent psychiatric disorders with the management of infectious complica tions, including immunodeficiency, promises to improve patient complia nce with possible savings of overall medical costs. Published by Elsev ier Science Inc.