MEDICAL CONSEQUENSES OF HTLV II IN DRUG ABUSERS

描述：(申请人摘要) 这是一项假设驱动的人类嗜T淋巴细胞病例对照研究。 II型病毒(HTLV-II)感染是肺炎和皮肤的危险因素 注射吸毒者软组织脓肿(IDU)。这很好 认识到注射吸毒者的传染病发病率很高，包括 细菌性肺炎和皮肤软组织脓肿。HTLV-II感染是 在吸毒者中流行，在各个国家的水平从5%到15%不等 州立城市。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者队列研究表明HTLV-II是 与细菌性肺炎的发病率增加有关，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，容易发生 吸毒者中的传染病，他们占感染HTLV-II的大多数 这个国家的受试者。拟议的调查包括两项 旧金山总医院注射吸毒者的同期病例对照研究。 诊断为细菌性肺炎的IDU病例；2)皮肤和软组织 组织脓肿(N=151)将在三年内平行入选 来自旧金山总医院的住院部和门诊部。 无上述疾病的IDU，并按年龄、种族和 住院/门诊状态，将同时登记到单个控制中 组(N-302)。血清学和聚合酶检测HTLV-II感染 在我们实验室中，链式反应将是主要的危险因素 所有受试者。关于注射毒品行为的信息(选择的药物， 注射毒品的时间和频率、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，以允许 对这些变量的混杂进行调整。HIV抗体将会是 作为可能的混杂变量进行测量，并评估相互作用 使用HTLV-II易患细菌性肺炎和脓肿。最后， 应用RFLP技术检测HTLV-II病毒亚型及免疫球蛋白G和CD4+/CD8+淋巴细胞 将对所有科目的水平进行测量。

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.