Intravenous drug-users comprise a major group of HIV-infected individuals in the developed world and, whilst progression of HIV disease in them appears little different from other risk groups, their medical presentations may be altered by continuing drug use. Drug-users are particularly susceptible to bacterial infections irrespective of their HIV status; they may present with symptoms directly caused by their drugs, which can be difficult to differentiate from non-drug-related causes and may closely resemble symptoms directly attributable to HIV. In addition, the life style associated with drug use can make compliance difficult, but in clinics combining HIV care and methadone prescribing these problems can be overcome.
SalmasoSContiSSasseH, And the Second Multicenter Study group on Drug Users. Drug use and HIV-1 infection: Report from the second Italian multicenter study. J AIDS1991;4:607–13.
2.
RobertC-FDeglonJ-JWintschJBehavioural changes in intravenous drug users in Geneva: Rise and fall of HIV infection, 1980–1989. AIDS1990;4:657–60.
3.
Update: Acquired immunodeficiency syndrome — United States, 1981–1990. MMWR1991;40:358–69.
4.
BrettleRPBissetKBurnsSHuman immunodeficiency virus and drug misuse: The Edinburgh experience. BMJ1987;295:421–4.
5.
McLachlanCCroftsNWodakACroweS.The effects of methadone on immune function among injecting drug users: A review. Addiction1993;88:257–63.
6.
BrodySLSlovisCMWrennKD.Cocaine-related medical problems: Consecutive series of 233 patients. Am J Med1990;88:325–31.
7.
HindCRK.Pulmonary complications of intravenous drug misuse. Epidemiology and non-infective complications. Thorax1990;45:891–8.
8.
BrettleRPGoreSMMcNeilA.Outpatient medical care of injection drug use related HIV. Int J STD AIDS1992;3:96–100.
9.
RonaldPJMRobertsonJRDuncanBMThomsonAS.Children of parents infected with HIV in Lothian. BMJ1993;306:649–50.
10.
LouriaDBHensleTRoseJ.The major medical complications of heroin addiction. Ann Intern Med1967;67:1–22.
11.
CherubinCE.The medical sequelae of narcotic addiction. Ann Mem Med1967;67:23–33.
12.
HusseyHHKatzS.Infections resulting from narcotic addiction. Am J. Med1950;9:186–93.
13.
WelchGHReidDBPollockJG.Infected false aneurysms in the groin of intravenous drug abusers. Br J Surg1990;77:330–3.
14.
StonebridgePACallamMJFaroukMMurieJA.Intraarterial injection of oral medication in HIV positive drug addicts. Br J Surg1990;77:333–4.
15.
HusseyHHKeliherTFSchaeferBFWalshBJ.Septicaemia and bacterial endocarditis resulting from heroin addiction. JAMA1944;126:535–40.
Increase in pneumonia mortality among young adults and the HIV epidemic — New York City, United States. MMWR1988;37:593–6.
18.
ManosGEvan DeutekomHPeerboomsPGHvan DoornumGJJCourinhoRA.Community-acquired pneumonia in drug abusers in Amsterdam. Lancet1990;ii:940–l.
19.
SelwynPAFeingoldARHartelDIncreased risk of bacterial pneumonia in HIV-infected intravenous drug users without AIDS. AIDS1988;1:267–72.
20.
WoodheadMAMacFarlaneJTMcCrackenJSRoseDHFinchRG.Prospective study of the aetiology and outcome of pneumonia in the community. Lancet1987;i:671–7.
21.
HindCRK.Pulmonary complications of drug misuse. Infective and HIV related complications. Thorax1990;45:957–61.
22.
DallySThomasGDananM.Candidiasis in heroin abusers. BMJ1983;287:1549.
23.
CollignonPJSorrellTC.Disseminated candidiasis: Evidence of a distinctive syndrome in heroin abusers. BMJ1983;287:861–2.
24.
HoyJSpeedB.Candidiasis in heroin abusers. BMJ1983;287:1549.
25.
RiederHLCauthenGMKellyGDBlochABSniderDE.Tuberculosis in the United States. JAMA1989;262:385–9.
26.
SelwynPASckellBMAlcabesPFriedlandGHKleinRSSchoenbaumEE.High risk of active tuberculosis in HIV-infected drug users with cutaneous anergy. JAMA1992;268:504–9.
27.
SelwynPAHartelDLewisVAA prospective study of the risk of tuberculosis among intravenous drug users with human immunodeficiency virus infection. N Engl J Med1989;320:545–50.
28.
BloomBRMurrayCJL.Tuberculosis: Commentary on a reemergent killer. Science1992;257:1055–64.
29.
FriedenTRSterlingMPHPablos-MendezAKilburnJOCauthenGMDooleySW.The emergence of drug resistant tuberculosis in New York City. N Engl J Med1993;328:521–6.
30.
ChamotEHirschelBWintschBLoss of antibodies against hepatitis C virus in HIV-seropositive intravenous drug users. AIDS1990;4:1275–7.
31.
ChamotEde SaussurePHHirschelBDeglonJJPerrinLH.Incidence of hepatitis C, hepatitis B and HIV infections among drug users in a methadone-maintenance programme. AIDS1992;6:430–1.
32.
HartGJWoodwardNJohnsonAMTigheJParryJVAdlerMV.Prevalence of HIV, hepatitis B and associated risk behaviours in clients of a needle exchange in central London. AIDS1991;5:543–7.
33.
GruerLDPeecDeMCarringtonDClementsGBFollettEA.Distribution of HIV and acute hepatitis B infection among drug injectors in Glasgow. Int J STD AIDS1991;2:356–8.
34.
van den HoekJARvan HaastrechtHJAGoudsmitJde WolfFCoutinhaRA.Prevalence, incidence and risk factors of hepatitis C virus infection among drug users in Amsterdam. J Infect Dis1990;162:823–6.
35.
MientjesGHMiedemaFvan AmeijdenEJFrequent injecting impairs lymphocyte reactivity in HIV-positive and HIV-negative drug users. AIDS1991;5:35–41.
36.
MientjesGHCvan AmeijdenEJCWeigelHMvan den HoekAJARCoutinhoRA.Clinical symptoms associated with seroconversion for HIV-1 misusers of intravenous drugs: Comparison with homosexual sero***convertors and infected and non-infected intravenous drug misusers. BMJ1993;306:371–3.
37.
GlassrothJAdamsGDSchnollS.The impact of substance abuse on the respiratory system. Chest1987;91:596–602.
38.
CamargoGColpC.Pulmonary function studies in ex-heroin users. Chest1975;67:331–4.
39.
OverlandESNolanAJHopewellPC.Alteration of pulmonary function in intravenous drug misusers. Am J Med1980;68:231–7.
40.
HughesSCaverleyPMA.Heroin inhalation and asthma. BMJ1988;297:1511–12.
41.
SmithHWBLibermanHABrodySLBatteyLLDonahueBCMorrisDC.Acute myocardial infarction temporarily related to cocaine use. Ann Intern Med1987;107:13–18.
42.
IsnerJMEstesNAMThompsonPAcute cardiac events related to cocaine abuse. N Engl J Med1986;315:1438–43.
43.
NanjiAAFilipenkoJD.Asystole and ventricular fibrillation associated with cocaine intoxication. Chest1984;85:132–3.
44.
MyerJAEarnestMP.Generalized seizures and cocaine abuse. Neurology1984;34:675–87.
45.
LevineSRWelchKMA.Cocaine and stroke. Stroke1988;19:779–83.
46.
EGanVGCrawfordJRBrettleRPGoodwinGM.The Edinburgh cohort of HIV-positive drug users: Current intellectual function is impaired, but not due to early AIDS dementia complex. AIDS1990;4:651–6.
47.
SelwynPAFeingoldARlezzaAPrimary care for patients with human immunodeficiency virus (HIV) infection in a methadone maintenance treatment program. Ann Intern Med1989;111:761–3.
48.
SluijsTAEsmanHCWeigelHMFrissenPHJVan BrusselGHA.Therapy compliance of HIV-infected intravenous drug users (IVDU). VIII International Conference on AIDS, Final Program and Abstracts, vol 2, pp D512 [Abstract PoD 5741].
49.
SchwartzELBrechbuhlA-BKahlPMillerMASelwynPAFriedlandGH.Pharmacokinetic interactions of zidovudine in intravenous drug-using patients with HIV infection. J AIDS1992;5:619–26.
50.
KreekMJGarfieldJWGutjahrCLGuistiLM.Rifampicin induced methadone withdrawal. N Engl J Med1976;294:1104–6.
51.
KennerRMFoleyKM.Patterns of narcotic use in a cancer pain clinic. Ann N Y Acad Sci1981;362:161–72.
52.
LebovitsAHLefkowitzMMcCarthyDSimonRWilponHJungRFriedE.The prevalence and management of pain in patients with AIDS: A review of 134 cases. Clin J Pain1989;5:245–8.
53.
BreibartW.Psychiatric aspects of pain and HIV disease. Focus1990;5: No 9, 1–2.
54.
FairzoKMBuehlerJWChamberlandMESpectrum of disease in persons with human immunodeficiency virus infection in the United States. JAMA1992;267:1798–805.
55.
RezzaGLazzarinAAngaranoGThe natural history of HIV infection in intravenous drug users: Risk of disease progression in a cohort of seroconvertors. AIDS1989;3:87–90.
56.
SelwynPAAlcabesPHartelDClinical manifestations and predictors of disease progression in drug users with human immunodeficiency virus infection. N Engl J Med1992;327:1697–703.
57.
StoneburnerRLDes JarlaisDCBenezraDA larger spectrum of severe HIV-1-related disease in intravenous drug users in New York City. Science1988;242:916–18.
58.
PayneSFRutherfordGWLempGFClevengerAC.Effect of the revised AIDS case definition on AIDS reporting in San Francisco: Evidence of increased reporting in intravenous drug users. AIDS1990;4:335–8.
59.
BeralVPetermanTABerkelmanRLJaffeHW.Kaposi's sarcoma among person with AIDS: A sexually transmitted infection?Lancet1990;i:123–8.
60.
Gachupin-GarciaASelwynPABudnerN. SalisburyPopulation-based study of malignancies and HIV infection among injecting drug users in a New York City methadone treatment program, 1985–1991. AIDS1992;6:843–8.
61.
MonfardiniSVaccherEPizzocaraGUnusual malignant tumours in 49 patients with HIV infection. AIDS1989;3:449–52.
62.
SunderamGMcDonaldRJManiatisTOleskeJKapilaRReichmanLB.Tuberculosis as a manifestation of the acquired immunodeficiency syndrome (AIDS). JAMA1986;256:362–6.
63.
Tuberculosis and acquired immunodeficiency syndrome — New York City. MMWR1987;36:785–95.
64.
JordanTJLewitEMMontgomeryRLReichmanLB.Isoniazid as preventative therapy in HIV-infected intravenous drug users. JAMA1991;265:2987–91.
65.
ConteDMandelliCCesanaBMT4+ cell depletion as a major risk factor for AIDS-related complex and AIDS. Longitudinal study of 253 HIV-antibody positive heroin addicts from northern Italy. Int ***J STD AIDS1991;2:37–40.
66.
Fernandes-CruzEDescoMMontesM GarciaLongoNGonzalezBZabayJM.Immunological and serological markers predictive of progression to AIDS in a cohort of HIV-infected drug users. AIDS1990;4:987–94.
67.
MargolickJBMunozAVlahovDChanges in T-lymphocyte subsets in intravenous drug users with HIV-1 infection. JAMA1992;267:1631–6.
68.
MunozAVlahovDSolomonLPrognostic indicators for development of AIDS among intravenous drug users. J AIDS1992;5:694–700.
69.
ZangerleRFuchsDReibneggerGFritschPWachterH.Markers for disease progression in intravenous drug users infected with HIV-1. AIDS1991;5:985–91.
70.
ZangerleRWachterHFuchsD.Immune activation markers and CD4+ T-cell counts in HIV-infected intravenous drug users. J AIDS1992;5:1273–4.
71.
FleggPJBrettleRPRobertsonJRClarksonRCBirdAG.B2 microglobulin levels in drug users: The influence of risk behaviour. AIDS1991;5:1021–4.
72.
WeberRLedergerberBOpravilMSiegenthalerWLuthyR.Progression of HIV infection in misusers of injected drugs who stop injecting or follow a programme of maintenance treatment with methadone. BMJ1990;301:1362–5.
73.
WittDJCravenDEMcCabeWR.Bacterial infections in adult patients with the acquired immune deficiency syndrome (AIDS) and AIDS-related complex. Am J Med1987;82:900–6.
74.
MientjesGHvan AmeijdenEJvan der HoekAJARCoutinhoRA.Increasing morbidity without rise in non-AIDS mortality among HIV-infected intravenous drug users in AmsterdamAIDS1992;6:207–12.
75.
GoodwinGMChiswickAEganVSt ClairDBrettleRP.The Edinburgh cohort of HIV-positive drug users: Auditory event-related potentials show progressive slowing in patients with Centers for Disease Control stage IV disease. AIDS1990;4:1243–50.
76.
McKegneyFPO'DowdMAFeinerCSelwynPDruckerEFriedlandGH.A prospective comparison of neuropsychologic function in HIV-seropositive and seronegative methadone-maintained patients. AIDS1990;4:565–9.
77.
VillaAForestiVConfalonieriF.Autonomic nervous system dysfunction associated with HIV infection in intravenous heroin users. AIDS1992;6:85–9.
