Immunologic and viral markers in the circulation of anti-HIV negative heroin addicts

Abstract. 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 immuno-blot assay (RIBA-II). 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 83.3% 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 = 0.0001) and with both of the predominant antibodies (anti-C33c and anti-C22–3) of the HCV (P<0.01 and P<0.05 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 RF (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.