COMPARATIVE EPIDEMIOLOGICAL AND IMMUNOLOGICAL CHARACTERISTICS OF PATIENTS WITH HIV/HCV COINFECTION AMONG INJECTING DRUG USERS AND PATIENTS WITHOUT DRUG HISTORY IN THE REPUBLIC OF TATARSTAN

Introduction. The high prevalence of HIV/HCV coinfection among injection drug users (IDUs) in the Republic of Tatarstan necessitates studying the influence of behavioral factors on immunopathology.

Objective. To conduct a comparative analysis of immunological parameters in IDUs with HIV/HCV coinfection and those without a history of drug use.

Materials and Methods. This single-center comparative study included 38 patients with HIV/HCV coinfection who used injection drugs and 36 patients with HIV/HCV without a history of drug use. The sample size was calculated to achieve 80% power at a significance level of p < 0.05. Lymphocyte subpopulation composition and circulating immune complex levels were assessed.

Results. In the IDU group, a significantly more pronounced decrease in the level of CD4⁺-lymphocytes (26.2±0.7% vs. 30.1±0.8%; p<0.001) and the absolute number of CD4⁺-cells (0.43±0.04 vs. 0.61±0.04 ×10⁹/l; p<0.01) was revealed. The immunoregulatory index was significantly lower in the IDU group (0.60±0.02 vs. 0.75±0.02; p<0.001). The level of circulating immune complexes (CIC) was significantly higher in the IDU group (568.3±30.5 vs. 402.3±28.0 c.u.; p<0.001). In clinical stage III of HIV infection, IDUs demonstrated the greatest reduction in absolute lymphocyte count (24.1±0.9% vs. 31.3±1.6% in stage II; p<0.001).

Conclusions. Injection drug use is an independent factor exacerbating immune dysfunction in HIV/HCV coinfection. These findings support the need to develop differentiated approaches to monitoring and treating this patient population.

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