For patients with HIV, occasional heroin use may be particularly harmful to the immune system and worsen disease condition, results of a study published in AIDS and Behavior indicate.

“Opioids have immunosuppressive properties, yet their impact on HIV disease progression remains unclear,” noted E. Jennifer Edelman, MD, of Yale University in New Haven, Conn. and colleagues.

To estimate the effect of heroin use on HIV disease progression, the investigators conducted a pilot study with HIV-positive antiretroviral therapy (ART) –naive Russian patients (n=77). Heroin use was categorized by self-reported use at 30 days, six months, and 12 months as none, intermittent, or persistent.

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The researchers measured the change in CD4 count from baseline to 12 months, using multivariable linear regression to estimate the effect of heroin use on HIV progression. A higher CD4 cell count signals a stronger immune system.

Of the patients, those who reported intermittent (n=21) and no heroin use (n=39) experienced mean decreases in CD4 count from baseline to 12 months. The patients who reported persistent use (n=17) showed a mean increase of 53 cells/mm3 (adjusted mean difference, 63; 95% CI: -95 to 220).

“This manuscript represents an important step towards identifying the need for future study of the effects of heroin withdrawal on HIV disease progression, as it may have unique effects compared with chronic and no heroin use,” said Edelman in a university press release.


  1. EJ Edleman et al. AIDS and Behavior. 2014; doi: 10.1007/s10461-014-0948-z