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HIV-1 and Opioids 

HIV-1 and Opioids
Chapter:
HIV-1 and Opioids
Author(s):

Toby K. Eisenstein

, Jessica Breslow

, Changcheng Song

, Mathew J. Finley

, William D. Cornwell

, Sumedha Chugh

, Joseph J. Meissler

, and Thomas J. Rogers

DOI:
10.1093/med/9780195399349.003.0023
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date: 17 June 2019

The opioid drugs of abuse have marked effects on many aspects of the immune system. As one example, µ-, ?-, and d-opioid receptors are expressed on several hematopoietic cell populations, and opioid ligands selective for these receptors can influence HIV replication when added to human lymphoid, monocytic, or microglial cultures in vitro. Nonetheless, determining whether opioid abuse alters the progression of HIV infection has proven difficult. Epidemiological studies are complicated by the fact that drug abusers typically take combinations of drugs, which may include cocaine, marijuana, alcohol, and/or nicotine from cigarette smoke, and these drugs can have opposing effects on cells of the immune system. Even when groups of individuals use the same combination of drugs, the ratios among the drugs, the doses, and the frequency of dosing is far from uniform. In addition, although laboratory evidence points to many potential direct and indirect pathways by which opioids might influence viral replication, the absence of small animal models to test HIV infectivity has imposed significant challenges. It is hoped that new studies currently underway, using the SIV/macaque model, will address more directly the influence of opioids on the progression of AIDS and the development of HIV-associated neurodegeneration. This chapter reviews many lines of research bearing on the influence of exogenous opioids on HIV disease.

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