Drug Injection Cessation in HIV Patients Can Reduce Immune Activation

A recently-published study evaluated the relationship between injection drug use and immune activation in people who inject drugs (PWID) and who have or do not have HIV. ¹ The researchers determined that reducing injection drug use can result in more positive health outcomes by reducing immune activation.

The study included participants who were current and former injectors, as well as participants who never injected. High prevalence of hepatitis C virus (HCV) among PWID made it difficult to distinguish between the effects of injection drug use and HCV infection, so the researchers compared immune markers between active PWID and individuals who had ceased injection for 1-4 months.

The researchers noted that although sharing injection equipment was not related to immune activation, frequency and duration of injection were related to the immune markers studied. Cessation of injection helped reduce immune activation, but only in the absence of HCV. Discontinuing injections may allow HCV-negative PWID to normalize their levels of immune activation.

The findings indicate that harm reduction efforts should include treatment of HCV infection and injection cessation or reduction in frequency.

“Harm reduction efforts for PWID should include treatment of HCV infection, to reduce immune activation and enhance related health benefits,” Martin Markowitz, MD, principal investigator from the Aaron Diamond AIDS Research Center, said in a press release about the study.² “A longitudinal study to test the impact of curing HCV on immune activation among PWID is underway by our group.”

The researchers concluded that determining the mechanisms of the relationship between injection drug use behaviors and immune activation is needed to achieve a comprehensive understanding and to improve health outcomes for PWID.

Reference

• Deren S, Cleland CM, Lee H, et al. Brief report: the relationship between injection drug use risk behaviors and markers of immune activation. JAIDS. 2017. 75(1):e8-e12. doi; 10.1097/QAI.0000000000001270
• Researchers examine the relationship between drug injection risk behaviors and immune activation [news release]. NYU’s website. https://www.nyu.edu/about/news-publications/news/2017/april/researchers-examine-the-relationship-between-drug-injection-risk.html. Accessed April 17, 2017.