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Injecting drug user - very worried
Sep 12, 2005

I have been addicted to heroin for 3 years and yesterday found out that I am HIV+. I think I got it from a sex worker. Will heroin affect my ability to fight off this virus?

Response from Dr. Frascino

Hello,

Thanks for your question. My response may come as a surprise to some readers. Most well-designed epidemiological studies of HIV-positive folks in the pre-HAART era have demonstrated no difference in the progression of HIV to AIDS and death between those who use illicit drugs, including the injection of heroin and cocaine, and non-drug users, although there are a few laboratory-based studies that suggest that heroin and cocaine increase HIV replication. With the introduction of newer more potent therapies (HAART), the more recent studies indicate that drug users may have more difficulty obtaining, adhering to and, consequently, benefiting from treatment.

So to specifically answer your question will heroin affect your ability to fight HIV? the answer has two parts. Heroin itself does not have a direct impact on HIV progression or response to HAART; however, for some folks, heroin will interfere with adherence to antiretroviral medications, i.e. taking the medications exactly as prescribed, not missing doses, etc. These folks will have a reduced or no benefit from HAART, leading to a poor clinical outcome.

Good luck.

Dr. Bob



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