Substance-associated elevations in monocyte activation among methamphetamine users with treated HIV infection

Area of Science:

• Immunology
• Infectious Diseases
• Addiction Medicine

Background:

• Microbial translocation and monocyte activation are known predictors of mortality in treated HIV patients.
• The independent contribution of substance use to these pathophysiological processes requires further investigation.

Purpose of the Study:

• To investigate whether stimulant use independently contributes to monocyte activation and intestinal barrier integrity in HIV-positive individuals.
• To examine the association between reactive urine toxicology for stimulants and substance use severity with specific plasma biomarkers.

Main Methods:

• A cross-sectional study of 84 virally suppressed, methamphetamine-using men who have sex with men (MSM).
• Plasma biomarkers including soluble CD14 (sCD14), soluble CD163 (sCD163), and intestinal fatty acid binding protein (iFABP) were measured.
• Associations between stimulant use (reactive toxicology) and substance use severity (Addiction Severity Index) with biomarkers were analyzed using multiple linear regression.

Main Results:

• Individuals with reactive toxicology for stimulants showed significantly higher sCD14 levels compared to those without.
• Greater substance use severity was independently associated with elevated sCD14 levels after adjusting for covariates.
• No significant associations were found between stimulant use or substance use severity and sCD163 or iFABP levels.

Conclusions:

• Monocyte activation, indicated by elevated sCD14, is a plausible mechanism linking stimulant use to increased clinical HIV progression.
• Findings highlight the importance of addressing substance use in the management of HIV to mitigate potential negative health outcomes.