BIOLOGICAL CHARACTERISTICS OF HIV-INFECTION AMONG INJECTING DRUG USERS IN HOCHIMINH CITY

 

Truong Xuan Lien*, Luong Thu Tram*, Nguyen Huu Chi**, Nguyen Hoang Lan***

* Pasteur Institute in HoChiMinh City

**Center for Tropical diseases, HoChiMinh City

*** Center for Preventive Medicine of HoChiMinh City

 

Objective

To have the background of principal biological parameters of HIV infected drug users in HoChiMinh city

Methods

254 HIV-positive (235 males and 19 females) and 46 HIV-negative injecting drug users from the Centre for Detoxification in HoChiMinh city were enrolled in this study during 12/1996.

For each individual, complete blood count (CBC), CD4/CD8 cell count, plasma viral load, HIV serology and non HIV serology such as: hepatitis B, C (HBV, HCV), syphilis, toxoplasmosis, cytomegalovirus (CMV), herpes simplex (HSV), varicelle-zona (VZ), HTLV...were performed.

Virus isolation and HIV-1 subtype determined by Heteroduplex Mobility Assay (HMA) were performed for 30 HIV-infected patients.

Results

1.       The mean value of hemoglobin and platelet count in both groups HIV-positive and HIV -negative drug users were normal. However, anemia was observed on 25% of HIV positive and only on 7% HIV-negative individuals (p<10-5). Thrombopenia was noticed only in 5 patients with HIV-positive (2%).

2.       Mean value of CD4-CD8 cell count:

There was a significant difference in mean CD4 cell count (p<109) and CD8 cell count (p<10-4) with HIV-positive individuals CD4 = 337; CD8 = 1114 compared to HIV -negative individuals (CD4= 719; CD8= 835)

Distribution by CD4 cell count by sex:

24% of HIV- positive males and 11 % of HIV positive females had CD4 cell counts of less than 200/mm3

3.       Plasma viral load:

The inverse correlation between low CD4 count and high viral load indicated the development of the late-stage infection.

4.       Non-HIV infection serology:

Seroprevalence rates of other non-HIV infection were strictly similar among both groups HIV-positive and HIV-negative peoples.

The prevalence of Cytomegalovirus, Herpes simplex, Varicelle-Zona were particularly high (98-100%) in both groups. The same status for Hepatitis B and C. HTLV1 and HTLV2-seropositive was about 80%. The rate of Toxoplasma was less than 10%. The prevalence of syphilis determined by TPHA among HIV-infected females, HIV-infected males, HIV-uninfected subjects were 50%, 27% and 29%, respectively.

* All 30 strains studied were identified as subtype E, which predominated in Vietnam.

Conclusion

HIV-1 subtype E was predominant among IDUs in HoChiMinh city. According to biological parameters, about 20% of HIV-infected patients were at the late stage of HIV infection. Seroprevalence of non-HIV infection were especially high for HBV, HCV, CMV, VZ, HSV and HTLV. The strict similarity in high seroprevalence rates for non-HIV infections between HIV infected and HIV-uninfected groups raises the questions of the resistance to HIV infection among high risk group drug users in HCM city.