# The impact of intravenous heroin use on immune activation in treated HIV

> **NIH NIH R01** · CASE WESTERN RESERVE UNIVERSITY · 2021 · $857,236

## Abstract

The proposal in this application will study the extent and specifics of immune activation, its cardiovascular
consequences, and mechanisms as they relate to gut integrity in HIV-infected intravenous (IV) heroin users
virologically-suppressed on antiretroviral therapy. Overreaching goals are 1) to define the extent and specifics
of immune activation in HV-infected IV heroin users; 2) to define the effect of IV heroin on gut integrity and
permeability, and the relationship of gut integrity alteration and immune activation; 3) importantly, to study the
reversibility of immune activation, inflammation, and gut dysfunction after cessation of IV heroin, and to that
effect, compare two strategies for medication assisted treatment—buprenorphine/naloxone versus methadone
maintenance; 4) to study if heightened immune activation associated with active intravenous drug use (IVDU)
is associated with higher cardiovascular disease risk, including endothelial dysfunction and arterial
inflammation, and if these effects are reversible with buprenorphine/naloxone or methadone. To answer these
complex questions an expert team has been assembled with the plan to recruit a cohort of ART-treated, HIV-
infected persons who use IV heroin, and very carefully matched HIV-infected controls who have never used IV
drugs. A second cohort of ART-treated HIV-infected persons who use IV heroin choosing medication assisted
treatment with either buprenorphine/naloxone or methadone to stop using will also be established. These
cohorts will be followed serially and data will be collected regarding virologic and immunologic responses to
continued IV heroin use versus no IVDU and to buprenorphine/naloxone versus methadone. Levels of cellular
activation with phenotyping of T-lymphocytes, as well as levels of soluble markers of immune activation and
inflammation will be measured. The effect and reversibility of IVDU on arterial inflammation and endothelial
dysfunction will be serially measured, before and after buprenorphine/naloxone or methadone.

## Key facts

- **NIH application ID:** 10160860
- **Project number:** 5R01DA044576-05
- **Recipient organization:** CASE WESTERN RESERVE UNIVERSITY
- **Principal Investigator:** Corrilynn Olesky Hileman
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $857,236
- **Award type:** 5
- **Project period:** 2017-07-01 → 2023-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10160860

## Citation

> US National Institutes of Health, RePORTER application 10160860, The impact of intravenous heroin use on immune activation in treated HIV (5R01DA044576-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10160860. Licensed CC0.

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