ACUTE AND CHRONIC EFFECTS OF COCAINE ON THE IMMUNE-SYSTEM AND THE POSSIBLE LINK TO AIDS

The pathogenesis of AIDS is a complex and prolonged process that is af fected by a variety of cofactors, including the abuse of both intraven ous and smoked (crack) cocaine. The exact mechanisms by which cocaine facilitates this disease are yet to be proven, but likely include a co mbination of increased risk due to cocaine-related social behaviours, a wide-ranging capacity for cocaine to suppress the immune system, and an effect of cocaine on the infectivity and replication of HIV. While sometimes contradictory, both human and animal studies document that cocaine alters the function of natural killer (NK) cells, T cells, neu trophils and macrophages, and alters the ability of these cells to sec rete immunoregulatory cytokines. In addition to these effects on the i mmune system, cocaine also enhances the infectivity and/or replication of HIV when tested using human cells in vitro. (C) 1998 Elsevier Scie nce B.V.