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Methamphetamine use may accelerate HIV progression
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Methamphetamine use may alter the expression of certain genes in individuals living with HIV and worsen the disease, according to findings published in Brain, Behavior, and Immunity.
“Prior research from my team in the Multicenter AIDS Cohort Study (MACS) found that more frequent stimulant users had 50% greater odds of clinical HIV progression,” Adam W. Carrico, PhD, associate professor of public health sciences and psychology at the University of Miami Miller School of Medicine, told Infectious Disease News. “These recently published studies help us to understand the biological mechanisms whereby stimulant use could independently contribute to HIV disease progression.”
Carrico and colleagues conducted a gene expression study that included 55 sexual minority men (gay, bisexual or men who have sex with men) who used methamphetamine and were HIV positive with a viral load of less than 200 copies/mL. Using RNA sequencing, researchers compared leukocyte gene expression patterns in participants whose urine samples tested positive for stimulants (n = 27) vs. those whose samples were negative (n = 28).
The researchers found that recent stimulant users displayed differential expression of 32 genes, as well as a perturbation of 168 pathways. Results suggested that recent stimulant use was associated with the upregulation of genes that govern HIV latency, the survival of HIV-infected cells, immune activation and inflammation. This could potentially allow HIV to become more active and expand the viral reservoir in stimulant users receiving effective HIV treatment.
Another study by Carrico and colleagues, which appears to support these findings, identified a possible mechanism for a stimulant-associated increase in HIV progression. The study showed that the soluble CD14 — a clinically relevant marker of monocyte activation — was elevated in virally suppressed HIV-positive men who recently used stimulants. This monocyte activation marker was previously shown to predict increased HIV progression as well as cardiovascular disease, they said.
“In terms of implications for clinicians, these results underscore the importance of screening for stimulant use disorders and providing referrals to substance abuse treatment,” Carrico said in the interview. “Effectively addressing stimulant use disorders could increase the likelihood that patients continue to derive maximum benefits from HIV treatment and may ultimately improve their health outcomes.” – by Marley Ghizzone
References:
Carrico AW, et al. Brain Behav Immun. 2018;doi:10.1016/j.bbi.2018.04.004.
Carrico AW, et al. AIDS. 2018;doi:10.1097/QAD.0000000000001751.
Disclosures: Carrico reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.