Immune profiling in Puerto Rican injection drug users with and without HIV-1 infection.

Antiretroviral therapy (ART) has been effective in suppressing HIV viral load and enabling people living with HIV (PLWH) to experience longer, more conventional lives. However, as PLWH are living longer, they are developing aging-related diseases prematurely and are more susceptible to comorbidities that have been linked to chronic inflammation. Coincident with HIV infection and aging, drug abuse has also been independently associated with gut dysbiosis, microbial translocation, and inflammation. Here, we hypothesized that injection drug use (IDU) would exacerbate HIV-induced immune activation and inflammation, thereby intensifying immune dysfunction. We recruited 50 individuals not using injection drugs (36/50 HIV+) and 47 people who inject drugs (PWID, 12/47 HIV+). All but three of the HIV+ subjects were on ART. Plasma immune profiles were characterized by immunoproteomics, and cellular immunophenotypes were assessed using mass cytometry. The immune profiles of HIV+/PWID-, HIV-/PWID+, and HIV+/PWID+ were each significantly different from controls; however, few differences between these groups were detected, and only three inflammatory mediators and two immune cell populations demonstrated a combinatorial effect of IDU and HIV infection. In conclusion, a comprehensive analysis of inflammatory mediators and cell immunophenotypes revealed remarkably similar patterns of immune dysfunction in HIV-infected individuals and in PWID with and without HIV-1 infection.