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Large diurnal variation in CD4 cell count and T-cell function among drug users: implications for clinical practice
G H Mientjes1, E J van Ameijden, M T Roos
1Municipal Health Service, Department of Public Health and Environment, Amsterdam, The Netherlands.
Objective:
To measure diurnal variation in the CD4 cell count and T-cell reactivity of drug users.
Design:
A prospective epidemiological study among HIV-infected and non-infected drug users attending the Municipal Health Service of Amsterdam, The Netherlands.
Patients:
Eleven HIV-infected and seven non-infected drug users.
Main Outcome Measures:
CD4 cell counts and T-cell reactivity three times a day. T-cell subsets and T-cell reactivity were determined from blinded samples within 2 hours.
Results:
The number of CD4 cells increased by 130 x 10(6)/l (P < 0.05) in HIV-infected intravenous drug users over 8 hours. Following stimulation with anti-CD3 monoclonal antibodies, the T-cell reactivity of HIV-infected drug users rose from 118 to 221 c.p.m. (P < 0.01) over 8 hours. CD4 cell counts of the total study population increased by 37% and T-cell reactivity by 93%. The increase in the number of CD4 cells was more marked among active drug users than among drug users who had not used drugs recently.
Conclusion:
Variation in the CD4 cell count and in T-cell reactivity is large among drug users.