Document 2399
 DOCN  M94A2399
 TI    Comparative analysis of HIV infection in men and women.
 DT    9412
 AU    Kadree M; Clark J; Division of Infectious Diseases, Morehouse School of
       Medicine,; Atlanta, GA 30310.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):313 (abstract no. PC0182). Unique
       Identifier : AIDSLINE ICA10/94370176
 AB    OBJECTIVE: To determine those differences in the clinical manifestations
       of HIV infection in females (F) and males (M), which may have
       substantial implications regarding clinical management. METHOD:
       retrospective chart review of 216 HIV-infected patients[pts]; pts.
       stratified by mean CD4 counts expressed in number/cu.mm; the number of
       OI events were reported as a function of the mean CD4 values; major
       criterion for inclusion: consistent follow-up over a minimum of 1 year.
       RESULTS: Seventy-eight pts met the inclusion criterion, F = 36, M = 42;
       mean length of time known to be HIV+: F = 2.2 years, M = 2.4 years; mean
       period of active clinical follow-up: F = 1.6 years, M = 1.4 years; F =
       28%, M = 43% were injection drug users [IDUs]; 91 OI events were
       recorded, F = 34, M = 57; oral candidiasis [OC]: M = 53%, F = 24%; for
       females--vaginal candidiasis = 20%; esophageal candidiasis: M = F = 9%.
       PCP: M = 25%; F = 27%. Surprising findings were: 1) the high percentage
       of OIs occurring at CD4 counts > 500 [F = 26%, M = 14%] and 2) the low
       frequency of OIs in females with CD4 values between 100-200 when
       compared with the 200-300 group [3% vs. 26%], a trend not observed in
       males. For both sexes, all the AIDS-defining OIs [ADOIs] in pts with CD4
       values > 500 occurred exclusively in IDUs. DISCUSSION AND CONCLUSION:
       The high number of OIs/ADOIs in IDUs with CD4 counts > 500 [range
       516-756], suggest that IDUs may have 1 degree CD4 dysfunction, another
       immune system derangement, or a higher systemic viral load [perhaps due
       to ongoing opiate use--morphine, in vitro, enhances HIV replication].
       The decrease in OIs in females following introduction of
       Trimethoprim/Sulfa [TMP/SX] may reflect a positive benefit from TMP/SX,
       a trend that was not noted for males. This may be due to gender
       differences in the pharmacokinetics and/or metabolism of TMP/SX. The
       results of this study raises important questions on the immunological
       impact of IDU on HIV infection in both sexes and possible gender
       differences in the frequency of certain OIs and metabolism of certain
       drugs, all of which have significant clinical ramifications and need to
       be explored prospectively.
 DE    AIDS-Related Opportunistic Infections/IMMUNOLOGY  Comparative Study
       Female  Human  *HIV Infections/COMPLICATIONS/IMMUNOLOGY  Leukocyte Count
       Male  Retrospective Studies  Substance Abuse, Intravenous/COMPLICATIONS
       T4 Lymphocytes  MEETING ABSTRACT

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