Immunologic Dysfunction in Heroin Addicts

TLDR

The etiology of the observed immune abnormalities in heroin users is unclear, and occult liver disease could not be ruled out. Heroin addicts exhibit widespread humoral and cellular immune dysfunction, including hypergammaglobulinemia, false‑positive syphilis, and impaired mitogen responses, with no clear link to liver disease.

Abstract

Thirty-eight heroin addicts, whose immunologic status was studied, had a high incidence of abnormalities, including hypergammaglobulinemia (IgM, 87% and IgG, 63%), false-positive test for syphilis (23%), and positive latex fixation test (21%). A defect in cellular immunity was demonstrated by impaired in vitro responsiveness in lymphocyte culture studies to at least one of three mitogens when compared to normal controls. Follow-up studies on ten addicts not taking heroin but involved in methadone maintenance programs failed to show a consistent pattern. This study demonstrates abnormalities in both the humoral and cellular immune systems in chronic heroin addicts. There was no apparent correlation between these abnormalities and the presence of clinical liver disease. Occult liver disease, however, was not excluded by liver biopsy, and the pathogenesis of these immunologic disturbances remains speculative.