Community-acquired opportunistic infections and defective cellular immunity in heterosexual drug abusers and homosexual men.

Important note: Information in this article was accurate in 1983. The state of the art may have changed since the publication date.

Community-acquired opportunistic infections and defective cellular immunity in heterosexual drug abusers and homosexual men.

Am J Med. 1983 Mar;74(3):433-41. Unique Identifier : AIDSLINE MED/83149915
Small CB; Klein RS; Friedland GH; Moll B; Emeson EE; Spigland I

Abstract: Fourteen previously healthy young patients with unusual community-acquired opportunistic infections were seen over a period of three years. They differ from patients previously described in that 11 were heterosexual drug abusers (including two women) and only three were homosexual men. There were eight Puerto Ricans, five blacks, and one white. Infections included Pneumocystis carinii pneumonia (seven), disseminated Mycobacterium intracellulare infection, histoplasmosis, cryptococcosis, and cytomegalovirus infection (one each), oral thrush (13), and Candida esophagitis (two). All patients had impaired cellular immunity manifested by cutaneous anergy and lymphopenia, and all 11 tested had a markedly decreased ratio of T helper/inducer cells to T suppressor/cytotoxic cells. Twelve had evidence of associated viral infection (Epstein-Barr virus in nine, cytomegalovirus in five, Herpes simplex type 2 in two). Clinical presentation was with a severe opportunistic infection or with a prodrome consisting of oral thrush and nonspecific findings including malaise, fever, lymphadenopathy, or cough. The syndrome of immunodeficiency and opportunistic infection occurs in nonwhite heterosexual drug abusers, not exclusively in white homosexual men, and patients may present for medical care before the onset of a severe opportunistic infection.

Keywords: Acquired Immunodeficiency Syndrome/EPIDEMIOLOGY/*IMMUNOLOGY Adult Candidiasis, Oral/COMPLICATIONS Comparative Study *Diacetylmorphine Female *Homosexuality Human Immunity, Cellular Infection/*ETIOLOGY Male Negroid Race New York City Pneumonia, Pneumocystis carinii/COMPLICATIONS Puerto Rico/ETHNOLOGY Substance Abuse/*COMPLICATIONS T-Lymphocytes/IMMUNOLOGY T-Lymphocytes, Suppressor-Effector/IMMUNOLOGY Virus Diseases/COMPLICATIONS JOURNAL ARTICLE

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