Drug Abuse and HIV/AIDS

Research Findings from September, 2004 Director's Report

This section lists selected summaries from NIDA funded research projects that investigate youth drug abuse and HIV/AIDS. The summaries provided were selected from recent issues of the Director's Report to the National Advisory Council on Drug Abuse. For a more comprehensive listing of NIDA funded projects see the Director's Report.

Immune System Parameters and Clinical Morbidity in Infants Exposed to Drugs and HIV in Utero

Recently published data from the Women and Infants Transmission Study (WITS) reported on associations between maternal drug use during pregnancy and lymphocyte subsets and clinical morbidity in uninfected infants born to HIV-infected mothers. WITS is a multi-site longitudinal study of the health of HIV-infected mothers and their children, as well as mother-to-child HIV transmission. It is jointly supported by NIAID, NICHD, and NIDA. The outcomes of HIV-exposed but uninfected infants is a major focus within WITS. The current report presents findings for infants through 2 years of age. The definition of drug use during pregnancy included use of cocaine, methadone, heroin, and other opiates. History of illness and clinical findings were recorded using standardized collection instruments for medical history and medical chart abstraction. Measurement of immune system parameters (CD4, CD8, CD19, NK cell lymphocyte percentage and absolute numbers) utilized standard laboratory procedures. A total of 401 of the 1436 uninfected infants were born to drug-using mothers. Infants born to drug-using mothers had lower gestational age and birth weight, and lower CD4 lymphocyte percentage over the first 4 months of life after adjusting for covariates and higher natural killer lymphocyte percentage. The clinical significance of the lower CD4 percentage and higher NK cell level remain unclear. The investigators suggest that future studies evaluating immunologic parameters in HIV-exposed but uninfected infants should control for the effect of drug exposure. They also indicate that additional research that includes functional assays of lymphocyte cell populations is needed in order to evaluate effects of drug exposure on immune function in addition to phenotype, whether such effects are transient or persist over time, and whether there is any clinical significance of such findings. Neu, N., Leighty, R., Adeniyi-Jones, S., et al. Immune Parameters and Morbidity in Hard Drug and Human Immunodeficiency Virus-Exposed but Uninfected Infants. Pediatrics, 113(5), pp. 1260-1266, 2004.