MEDICAL CONSEQUENSES OF HTLV II IN DRUG ABUSERS

描述：（申请人摘要） 这是一项假设驱动的病例对照研究， 病毒II型（HTLV-II）感染是肺炎和皮肤病的危险因素 注射毒品使用者（IDU）的软组织脓肿。 公 认识到注射吸毒者感染传染病的发病率很高， 细菌性肺炎和皮肤软组织脓肿。 HTLV-II感染是 在美国各地区，注射吸毒者中的流行率为5%至15%。 州城市。 来自我们实验室和多中心的最新数据 逆转录病毒流行病学供体队列研究表明，HTLV-II是 与细菌性肺炎、皮肤和 软组织脓肿、肺结核等感染。 我们假设 HTLV-II感染，由于轻微的免疫抑制， 注射吸毒者中的传染病，他们构成了HTLV-II感染的大多数 在这个国家的主题。 拟议的调查包括两个 在旧金山弗朗西斯科总医院的注射吸毒者中进行的同期病例对照研究。 诊断为1）细菌性肺炎的IDU病例;和2）皮肤和软组织 组织脓肿（各N=151）将在3年内平行入组 来自旧金山弗朗西斯科总医院的住院部和门诊部。 无上述疾病的静脉吸毒者，并按年龄、种族和 住院/门诊状态，将同时入组单一对照组 N-302组。 HTLV-II感染，通过血清学和聚合酶测定 在我们的实验室连锁反应，将是主要的危险因素衡量， 所有科目。 关于药物注射行为的信息（选择的药物， 药物注射的持续时间和频率，注射前的皮肤清洁） 以及其他药物和酒精的摄入量将通过面谈获得， 调整这些变量的混杂因素。 艾滋病毒抗体将是 作为可能的混杂变量进行测量，并评估相互作用 HTLV-II与细菌性肺炎和脓肿的易感性有关。 最后， HTLV-II病毒亚型（RFLP）、免疫球蛋白G和CD 4 +/CD 8+淋巴细胞 将测量所有受试者的水平。

DESCRIPTION: (Applicant's Abstract) This is an hypothesis-driven case control study of human T-lymphotropic virus type II (HTLV-II) infection as a risk factor for pneumonia and skin and soft tissue abscess among injection drug users (IDU). It is well recognized that IDU have a high incidence of infectious diseases, including bacterial pneumonia and skin and soft tissue abscess. HTLV-II infection is prevalent among IDU at levels ranging from 5 to 15 percent in various United States cities. Recent data from our laboratory and from the multicenter Retrovirus Epidemiology Donor cohort study suggest that HTLV-II is associated with an increased prevalence of bacterial pneumonia, skin and soft tissue abscess, tuberculosis and other infections. We hypothesize that HTLV-II infection, because of mild immunosuppression, predisposes to infectious disease among IDU, who comprise the majority of HTLV-II infected subjects in this country. The proposed investigation includes two concurrent case-control studies among IDU at San Francisco General Hospital. IDU cases with diagnoses of 1) bacterial pneumonia; and 2) skin and soft tissue abscess (N=151 each) will be enrolled in parallel over three years from the in- and outpatient departments of San Francisco General Hospital. IDU without the above diseases, and matched to cases by age, race and in/outpatient status, will be enrolled concurrently into a single control group (N-302). HTLV-II infection, as determined by serology and polymerase chain reaction in our laboratory, will be the main risk factor measured in all subjects. Information on drug injection behavior (drug of choice, duration and frequency of drug injection, skin cleaning prior to injection) and intake of other drugs and alcohol will be obtained by interview to allow adjustment for confounding by these variables. HIV antibody will be measured as a possible confounding variable, and also to assess interaction with HTLV-II in predisposing to bacterial pneumonia and abscess. Finally, HTLV-II viral subtype by RFLP, and immunoglobulin G and CD4+/CD8+ lymphocyte levels will be measured in all subjects.