Chronic Hepatitis C Virus Infection and the Proinflammatory Effects of Injection Drug Use. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Chronic inflammation, as defined by persistent immune activation, is associated with adverse clinical outcomes. People who inject drugs (PWID) have evidence of persistent immune activation. Here, in a cohort of PWID with or without hepatitis C virus (HCV) infection, we sought to dissect out the contribution of chronic HCV infection (common in PWID) from the effects of injection drug use itself. METHODS: Four groups of study volunteers were recruited: group 1 comprised active PWID; group 2, individuals who ceased injecting drugs 1-2 months before recruitment; group 3, individuals who ceased injecting drugs 3-4 months before recruitment; and group 4, healthy volunteers. Soluble and cell-associated markers of immune activation were quantified. RESULTS: HCV-viremic PWID have elevated levels of immune activation when compared to healthy volunteers. Cessation of injection drug use results in a decline in immune activation in the absence of HCV viremia, while HCV-viremic individuals who previously were PWID continue to harbor elevated levels of immune activation, as defined by increased levels of soluble CD14 and tumor necrosis factor α and by the presence of CD38+HLA-DR+ CD4+ and CD8+ T cells. CONCLUSIONS: Immune activation, a well-defined surrogate of poor clinical outcome that is elevated in PWID, can regress to normal levels in former injection drug users who are HCV aviremic. Therefore, enhanced harm-reduction efforts should incorporate aggressive treatment of HCV infection. CLINICAL TRIALS REGISTRATION: NCT01831284.

publication date

  • August 11, 2016

Research

keywords

  • Hepacivirus
  • Hepatitis C, Chronic
  • Inflammation
  • Substance Abuse, Intravenous

Identity

PubMed Central ID

  • PMC5079368

Scopus Document Identifier

  • 84994726244

Digital Object Identifier (DOI)

  • 10.1093/infdis/jiw373

PubMed ID

  • 27521361

Additional Document Info

volume

  • 214

issue

  • 9