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Is the History of Substance Abuse Correlated with Neuropsychiatric Disorders and Co-morbid HIV Infection? An Urban Population Study

R.B. Bassey#, S.N. Chapman#, M. Pessu, A. Jayam-Trouth, M.C. Gondré-Lewis

Background: Human Immunodeficiency Virus (HIV) infection remains a serious immunological disease with new infections in the U.S. disproportionately reported in minority populations, with the District of Columbia (DC) still having the highest HIV infection rate in the nation. Drug abuse and addiction is also prevalent in DC and has traditionally been linked to HIV/AIDS because of the likelihood for opportunistic infections. Despite this data, the relationship between HIV status, drugs of abuse, and the incidence of neurological disorders are scarcely reported for minority populations.

Method: We carried out a retrospective study on the prevalence of substance abuse in HIV and their association with neuropsychiatric comorbidities in an African American subpopulation in Washington DC, USA.

Findings: Our data suggests an 86 percent prevalence of drug use in the HIV patients with neuropsychiatric comorbidities, with cocaine use being significantly higher in patients with Major Depressive Disorder (MDD) and bipolar disorder (BD), and PCP use associated with patients with schizophrenia. The mean CD4 count was elevated in the patients with neuropsychiatric disease, and specifically in the MDD patient group, whereas CD8 counts were not influenced by a specific neuropsychiatric disease diagnosis, although elevated as expected for HIV status. A majority (2/3) of patients were on HAART therapy, however the records did not account for adherence.

Conclusion: These data suggest that neuropsychiatric comorbidities in HIV, is independent of HIV disease progression, but certain illicit drugs are correlated with the incidence of neuropsychiatric disease.