Immunologic and viral markers in the circulation of anti-HIV negative heroin addicts (original) (raw)

To assess the degree of immune system activation associated with addiction or hepatotropic viruses infection, we examined 60 HIV-negative heroin addicts for the presence of hepatitis B virus (HBV) infection markers, hepatitis C virus antibodies (anti-HCV), various auto-antibodies, and serum levels of soluble interleukin-2 receptors (sIL-2R). In addition, 28 anti-HCV positive patients comprising the disease control group, were also examined. Our results demonstrated a high prevalence of anti-HCV antibodies (61.7% and 90% with 1st and 2nd generation ELISA, respectively). Eighty-seven percent (87Yi) of the addicts positive for anti-HCV by the latter and 92.8% of the disease control patients, were also positive with 2nd generation recombinant immunoblot assay (RIBA-11). In 88.9% of anti-HCV positive addicts, antibody to C22-3 was the predominant (anti-C33c in 81.5%). Antibodies to C33c and C22-3 polypeptides were also more frequent in disease control group (92.8% and 85.7%, respectively). Anti-HCV antibodies were associated with increased transaminases (ALT or AST, P < 0.05), as well as with longer duration of addiction (P< 0.005). HBV infection markers (HBsAg, anti-HBc only and anti-HBs) were also present in the addicts ( 5 % , 28.3% and 26.7"/, respectively). Rheumatoid factors (RF) were detected in 36.7%, antinuclear antibodies (ANA) in 11.7%, antibodies (IgG and/or IgM) against cardiolipin (anti-CL) and double stranded DNA (anti-ds DNA) in 20% and 50%, respectively. RF, ANA, anti-CL and anti-dsDNA antibodies were also detected in the disease control group (32.10/, 89.3%, 28.5% and 28.5% respectively). Auto-antibodies of at least one specificity, were found in 83.3Y0 of addicts independently of anti-HCV antibodies, HBV infection markers, increased ALT or AST levels, and the duration of addiction. They were, on the other hand, associated in addicts with antibodies to the C22-3 polypeptide of HCV (P=O.OOOl) and with both of the predominant antibodies (anti-C33c and anti-C22-3) of the HCV Correspondence: E. V. Tsianos MD, Chief, Hepato-(P<0.01 and PxO.05 respectively) in the disease control group. Thirty-nine addicts (65%) and 50% of the disease control patients were found to have increased levels of sIL-2R. In contrast to the disease control group, serum sIL-2R levels of addicts were associated with R F (P < 0.05), anti-dsDNA ( P < 0.0005) and total auto-antibodies (P= 0.0005), while there was a slight negative correlation with the duration of addiction (r = -0.26, P < 0.05). However, sIL-2R levels, were not associated with HBV and HCV infection markers in both groups. We conclude that intravenous heroin addiction appears to be associated with an increased prevalence of HCV and non-organ specific auto-antibodies. The latter may be driven by C22-3 and C33c polypeptides of HCV. Increased sIL-2R levels attest to a cellular immune activation in addicts, which is slightly correlated with shorter duration of addiction, independently of HCV or HBV, but in association with auto-antibodies production.