Heroin Use Is Associated With Vascular Inflammation in Human Immunodeficiency Virus.
Heroin Use Is Associated With Vascular Inflammation in Human Immunodeficiency Virus.
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海洛因的使用与人类免疫缺陷病毒的血管炎症有关。
DOI：
10.1093/cid/ciac812
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
McComsey,GraceA
中科院分区：
文献类型：
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作者：
Hileman,CorrilynnO;Durieux,JaredC;Janus,ScottE;Bowman,Emily;Kettelhut,Aaren;Nguyen,Trong-Tuong;Avery,AnnK;Funderburg,Nicholas;Sullivan,Claire;McComsey,GraceA
背景海洛因使用可能与人类免疫缺陷病毒（HIV）感染协同作用，导致更大的免疫失调比任何一个因素单独。揭示这如何影响终末器官疾病是关键，因为它可能在艾滋病毒感染者（PWH）中看到的过度死亡率中发挥作用，尽管可以获得护理和抗逆转录病毒治疗，但仍使用海洛因。使用（18）F-氟脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）对使用和不使用海洛因的成年人进行的横断面研究，特异性炎症，包括主动脉（目标背景比[TBR]），脾脏和骨髓（标准化摄取值[SUV]）。HIV阳性[HIV+]海洛因+和HIV+海洛因阴性[海洛因-]之间主动脉TBR的未校正平均差异为0.43（P= 0.02）;然而，在HIV-中，无论海洛因使用状态如何，主动脉TBR相似。此外，艾滋病毒与海洛因使用状况的相互作用是显著的（P= 0.02），表明海洛因使用和高主动脉TBR之间的关系取决于艾滋病毒状态。另一方面，HIV（1.54 vs 1.68;P= .04，HIV+ vs HIV-的未校正估计均值）和海洛因使用均与较低的骨髓SUV相关，尽管海洛因的影响取决于性别（海洛因使用与性别的相互作用，P= .03）。HIV-海洛因使用的相互作用是不显着的脾或骨髓SUV.ConclusionsAortic炎症是最大的PWH谁使用海洛因，但矛盾的是，骨髓活动是最少在这组，这表明复杂的，可能是不同的病理生理在这些不同的终端器官。
BackgroundHeroin use may work synergistically with human immunodeficiency virus (HIV) infection to cause greater immune dysregulation than either factor alone. Unraveling how this affects end-organ disease is key as it may play a role in the excess mortality seen in people with HIV (PWH) who use heroin despite access to care and antiretroviral therapy.MethodsThis is a prospectively enrolled, cross-sectional study of adults with and without HIV who use and do not use heroin using (18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) to compare tissue-specific inflammation including aortic (target-to-background ratio [TBR]), splenic, and bone marrow (standardized uptake value [SUV]).ResultsA total of 120 participants were enrolled. The unadjusted mean difference in aortic TBR was 0.43 between HIV-positive [HIV+] heroin+ and HIV+ heroin-negative [heroin−] (P= .02); however, among HIV−, aortic TBR was similar regardless of heroin-use status. Further, HIV-by-heroin-use status interaction was significant (P= .02), indicating that the relationship between heroin use and higher aortic TBR depended on HIV status. On the other hand, both HIV (1.54 vs 1.68;P= .04, unadjusted estimated means for HIV+ vs HIV−) and heroin use were associated with lower bone marrow SUV, although the effect of heroin depended on sex (heroin-use-by-sex interaction,P= .03). HIV-by-heroin-use interaction was not significant for splenic or bone marrow SUV.ConclusionsAortic inflammation was greatest in PWH who use heroin, but paradoxically, bone marrow activity was the least in this group, suggesting complex and possibly divergent pathophysiology within these different end organs.