Crystal meth and HIV

Shane, an HIV+ patient diagnosed in 2007, began antiretroviral medication a year ago. Within two months he reached goal: HIV viral load was <48 copies per ml, (This is considered undetectable) and his CD4 subset or what is also referred to as T cells, hovered at 450.

Based on this, it was my opinion that this forty five year old male, who was otherwise healthy, would remain stable on his current regimen as long as he was one hundred percent compliant with his meds. That meant taking them as directed daily.

Last month he came in for a routine visit. Blood was drawn and several days later when I received the results, something was seriously wrong. His CD4 dropped to 231 and his viral load rose to 170 copies per ml. Immediately I called him. “Have you been taking your medication faithfully?”

“Yes,” he replied. “Never missed a dose.”

“Have you been feeling ill or has anything changed in the past couple of weeks?”

“Nothing out of the ordinary as I can recall.”

“Have you been using recreational drugs?”

“Why can that have an affect on my T cells and viral load?”

Good question.

“Yes possibly.”

“Last week I did some crystal with my boyfriend, but we stayed at home and didn’t go out. It was only that one time, and that was one week before I had my blood drawn.”


A week ago I attended an HIV speakers training hosted by a pharmaceutical company. One of the lecturers gave a talk on recreational drugs and HIV. The doctor provided no insight as to the affects of crystal methamphetamineon T cell proliferation or viral load. In fact, he didn’t offer any information that I didn’t know already. There is limited data on the affect of recreational drugs on HIV and their affect on antiretroviral medication. Most resources state the well known fact that drugs, particularly crystal meth, is associated with an increase in high risk sexual behavior leading to HIV.

My own clinical experience leads me to believe that crystal meth decreases CD4 cell count, but this information is anecdotal.

Today Shane came in to have his blood drawn. “I haven’t used crystal in two weeks and before then I hadn’t used crystal in 2 years.”

I’m curious to see what his numbers will be?

June 19, 2009

Shane’s T cells rose to 295 and his viral load is undetectable again. Currently, he has not used crystal for one month. 





  1. John Doe
    Posted June 12, 2009 at 5:10 pm | Permalink

    A very close friend of mine has been on meds since 2001. At start t-cells were around 250 and v-load 200,000. Within 6-9 months viral load was undetectable and t-cells 400+. Since then pattern of adherence to meds has varied considerably over time, average over the past year 75-80% estimate. Since 2001 use of crystal meth has increased from rarely to occasionally to (for the last 2-3 years) between regularly to constantly. I have been concerned how his behavior has been effecting his life and health and have monitored all his blood tests since 2001. To my surprise his viral load has remained undetectable throughout and his t-cell count has varied from 800 and 1200 for the last 6 years, with no obvious pattern of change to link to his increased meth use or inconsistent adherence to meds. Not a recommending this behavior in any way, just an unscientific observation of one person’s experience. Odd how little is known about this given observations on the link between meth use and HIV infection rates.

  2. spinellimd
    Posted June 12, 2009 at 6:02 pm | Permalink

    Thank you for your comments.

    I strongly agree with your last point: little is known about crystal meth and its affect on HIV in light of the widespread use of this drug.

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