Chronic viral hepatitis is a significant contributor to the immunosenescent phenotype of parenteral drug addiction

Reece, Albert S. (2009) Chronic viral hepatitis is a significant contributor to the immunosenescent phenotype of parenteral drug addiction. Addiction Biology, 14 2: 214-226. doi:10.1111/j.1369-1600.2008.00123.x


Author Reece, Albert S.
Title Chronic viral hepatitis is a significant contributor to the immunosenescent phenotype of parenteral drug addiction
Journal name Addiction Biology   Check publisher's open access policy
ISSN 1355-6215
Publication date 2009-04-01
Year available 2008
Sub-type Article (original research)
DOI 10.1111/j.1369-1600.2008.00123.x
Volume 14
Issue 2
Start page 214
End page 226
Total pages 13
Editor Rainer Spanagel
Place of publication United Kingdom
Publisher Wiley-Blackwell Publishing Ltd.
Language eng
Subject C1
0601 Biochemistry and Cell Biology
Abstract Intravenous drug addiction is known to be associated with an inordinate morbidity and mortality. As our previous report had identified an immune phenotype consistent with accelerated ageing, we wished to investigate how much of this change may have been related to chronic viral hepatitis. A total of 12 409 clinical pathology results from the period 1995–2007 were reviewed. To control for the differences in age, only patients less than 48 years of age were considered. A total of 636 substance use disorder (SUD) and 6103 non-SUD (N-SUD) patients were studied. They had comparable ages (mean ± SD 31.32 ± 6.90 versus 31.57 ± 9.23, P-value not significant), but the SUD group had more males (74.37% versus 53.20%, P < 0.001). For most of the changes examined splitting the two SUD groups into hepatitis C positive (HCV+) and hepatitis C negative (HCV−) demonstrated that the majority of the described changes were most marked in the HCV+ group. The globulins were higher in the HCV+ group and the albumin was lower and fell more markedly with age than in N-SUD or HCV− (all P < 0.001). The globulin/albumin ratio was significantly higher in HCV+ than HCV− or N-SUD (both P < 0.0001) and rose more with age. These changes were paralleled by the ESR, elevations in the CRP and lymphocyte count. Transaminases were elevated in SUD and HCV+ groups compared with N-SUD (all P < 0.02). At multivariate analysis ESR, lymphocyte count, dual hepatitis B and C seropositivity, AST and HCVAb were significant predictors of the serum globulin level and accounted for 21% of the variance. These data extend our earlier report and show that much of the immunosenescent phenotype of SUD, encompassing the known immunosuppression and the observed immunostimulation, is statistically related to chronic viral hepatitis. Important theoretical and practical management (vaccination) implications ensue.
Keyword Addiction
cannabis
hepatitis C
heroin
immunosuppression
opiates
Q-Index Code C1
Q-Index Status Confirmed Code

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2009 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Tue, 16 Jun 2009, 01:26:39 EST by Cameron Harris on behalf of Office of Sponsored Research