Abstract
Human immunodeficiency virus (HIV) infection remains a serious immunological disease with new infections in the U.S. disproportionately reported in minority populations. For many years, the District of Columbia (DC) has reported the highest HIV infection rate in the nation. Drug abuse and addiction is also prevalent in DC and has traditionally been linked to HIV/AIDS because of the likelihood for opportunistic infections. Despite this data, the relationship between HIV status, drugs of abuse, and the incidence of neurological disorders are scarcely reported for minority populations. We carried out a retrospective study on the prevalence of substance abuse in HIV and their association with neuropsychiatric comorbidities in an African American subpopulation in Washington DC. Our data suggests an 86 percent prevalence of drug use in the HIV patients with neuropsychiatric comorbidities, with cocaine use being significantly higher in patients with major depressive disorder (MDD) and bipolar disorder (BD), whereas PCP use was associated with patients with schizophrenia. The mean CD4 count was elevated in patients with neuropsychiatric disease, and specifically in MDD patients. CD8 counts were elevated as expected for HIV status but were not influenced by disease diagnosis. A majority (2/3) of patients were on HAART therapy, however the records did not account for adherence. These data suggest that neuropsychiatric comorbidities are independent of HIV disease progression but are correlated with certain illicit drugs of abuse.
Highlights
These data suggest that neuropsychiatric comorbidities are independent of Human Immunodeficiency Virus (HIV) disease progression but are correlated with certain illicit drugs of abuse
People living with HIV/Acquired Immune Deficiency Syndrome (AIDS) face an additional burden of psychiatric comorbidity, where approximately 40% of patients with HIV infection will develop central nervous system (CNS) involvement [4]
Relationship of drugs of abuse with neuropsychiatric disease in HIV patients To test the possibility that a specific drug class may contribute to or exacerbate mental health disease, we evaluated major depressive disorder (MDD), bipolar disorder (BD), or SCZ, in correlation with nicotine, alcohol, cocaine, cannabis, heroin, or PCP use
Summary
Substance abuse is significantly associated with earlier progression to Acquired Immune Deficiency Syndrome (AIDS) in Human Immunodeficiency Virus (HIV)-infected people [1,2]. HIV may remain dormant in the CNS for many years, its mere presence might lead to subtle deficits in cognitive functioning. These deficits are not found in all patients, which has led some authors to suggest that peripheral triggers might be involved [5]. Drug abuse and addiction is prevalent in DC and has traditionally been linked to HIV/AIDS because of the likelihood for opportunistic infections. Despite this data, the relationship between HIV status, drugs of abuse, and the incidence of neurological disorders are scarcely reported for minority populations
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