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National Institute on Drug Abuse

Director's Report to the National Advisory Council on Drug Abuse

May, 1996

Research Findings

AIDS Research

Maternal Antibodies in HIV-Uninfected Infants

The presence of human immunodeficiency virus (HIV)-specific maternal antibodies bound to the peripheral blood mononuclear cells (PBMCs) was observed in 39 uninfected infants born to HIV-infected women. Such antibodies were not observed on PBMCs of 13 infants in whom maternal-child transmission of HIV had occurred. These results suggest that PBMC-bound maternal antibodies might have a protective role in the transmission of HIV from mothers to infants. Wang X-P, Oyaizu N, and Pahwa S. Pediatric Research, 38: pp. 384-389, 1995.

Neuropsychological Effects of Non-IV Drug Use and HIV Status

Research conducted by Dr. Robert A. Bornstein of Ohio State University examined the neuropsychological performance of HIV+ symptomatic, HIV+ asymptomatic, and HIV- individuals who had never abused drugs, had past histories of drug use, or currently abused drugs. The results revealed that with increasing proximity to time of drug use, HIV+ groups began to have worse performances than the HIV- group. There were no differences between the HIV-, HIV+ asymptomatic, and HIV+ symptomatic groups who had never abused drugs. The findings suggest that drug use may potentiate the expression of cognitive deficits in HIV infection.

Correlates of Hepatitis C Virus Infections Among Injection Drug Users

Recent analysis of the correlates of Hepatitis C infection from a long-term cohort study of the natural history of HIV infection among active IDUs found a very high prevalence of infection. HCV antibodies were detected in 89% of the participants (N=1356), and prevalence increased with age and with the duration of drug use: anti-HCV was present in 94% of those who had injected over 10 years. Prevalence was also higher in those who injected at least daily, among those sharing needles, and among those injecting cocaine. Prevalence was also significantly higher in those also HIV infected (93%) compared with HIV negatives (87%). No evidence for sexual acquisition of HCV was found. This study demonstrated that HCV infection occurs rapidly after the initiation of illicit drug injection: 78% of study participants were anti-HCV positive after 2 years of injecting. Thomas D, Vlahov D, Solomon L, Cohn S, Taylor E, Garfein R, Nelson K, Medicine, In Press, 1995.

Detection of HIV-1 DNA in Needle/Syringes, Paraphernalia, and Washes from Shooting Galleries in Miami: A Preliminary Report

With support from NIDA grants, Drs. Shah, Shapshak, Rivers, Stewart, Weatherby, Page, Chitwood, Mash, Vlahov, and McCoy conducted a study to detect the presence of HIV-1 DNA in injection paraphernalia and wash waters obtained from shooting galleries in Miami. Antibodies to HIV-1 proteins were detected in 52% of the visibly contaminated needles, 18% of the cottons, 14% of the cookers, and 6.0% of the washwater samples. HIV-1 DNA (gag, envelope) was detected in 84% and 85%, respectively, of the contaminated needles, 27% and 36% of the cottons, 46% and 56% of the cookers, and 38% and 67% of the washwater samples. The authors conclude that HIV-1 might be present in contaminated cottons, cookers, and washwater as well as in contaminated needle/syringes in shooting galleries. A key implication from these findings is that infection risks may reside in the behaviors of IDUs, independent of the effects of needle/syringe exchange programs. Reduction of Risks of Exposure to HIV-1 Among IDUs May Require Modification of Behaviors that are Ancillary to the Act of Injection, Such as the Use of Common Cookers, Cottons, and Washwater. JAIDS, 11: pp. 301-306, 1996.

Linked HIV Epidemics in San Francisco

Drs. Susan Service and Sally Blower assessed linkages between the first wave of HIV infection through the gay community in San Francisco in the early 1980s and the second wave that is now occurring among young gay men in the city. HIV seroprevalence is extremely age stratified in the gay community of San Francisco (42% of gay men >age 30 vs 18% of gay men
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