Drug Abuse Research on GALT and HIV Pathogenesis

Funding Source: National Institute on Drug Abuse (Administrative Supplement to CDUHR)
Principal Investigator: Sherry Deren, Ph.D.
Other Project Staff: Martin Markowitz, M.D. (Aaron Diamond AIDS Research Center)

Studies of HIV infection in humans have demonstrated that CD4+ T cells within the gastrointestinal (GI) mucosa are targeted and depleted. (About 70% of the immune system in humans is located in the GI tract. This part of the immune system is referred to as gut-associated lymphoid tissue (GALT).) Studies in HIV-positive people have primarily been based on non drug-using populations of men who have sex with men (MSM). This two-year administrative supplement to CDUHR has been funded to expand this research to HIV-infected injection drug users (men and women). The study will explore whether active injection drug use accelerates CD4+ T cell depletion in the GI tract using flexible sigmoidoscopy and biopsy. In addition, the role of behavioral risks (e.g., syringe sharing) will also be examined in terms of HIV disease progression. The study will recruit 90 persons, categorized by IDU status, HIV infection status, and viremia. Participants will be referred from two ongoing CDUHR-affiliated studies: the National HIV Behavioral Surveillance: New York City; and Peer Driven Intervention to Enroll Minorities/Women in HIV/AIDS Clinical Trials. Comparisons will be undertaken to assess the impact of injection drug use, viremia, and behavioral variables on CD4+ cell depletion. This integrated biomedical-behavioral research approach furthers the CDUHR aim of expanding interdisciplinary studies, and can serve as the basis for further collaborative efforts.