High prevalence of injection drug use and blood-borne viral infections among patients in an urban emergency department

Anderson, Eric G.; Russell, Carly; Basham, Kellie; Montgomery, Martha; Lozier, Helen; Crocker, Abigail; Zuluaga, Marisa; White, Douglas A.E.

doi:10.1371/journal.pone.0233927

Cited by 23 publications

(18 citation statements)

References 24 publications

(27 reference statements)

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“…1 This is due to the fact that the opioid epidemic has led to an increase in the number of persons who inject drugs, and this population accounts for 60% of new HCV infections in the United States annually. 2,3 HCV D+ kidneys have historically been associated with a high discard rate. 2 The use of direct-acting antiviral drugs (DAAs) may allow for safe transplantation of D+ kidneys into needy HCV negative recipients (R−).…”

Section: Introductionmentioning

confidence: 99%

“…2,3 HCV D+ kidneys have historically been associated with a high discard rate. 2 The use of direct-acting antiviral drugs (DAAs) may allow for safe transplantation of D+ kidneys into needy HCV negative recipients (R−). Recent clinical trials have shown that the strategy of HCV D+/R− transplantation followed by 8-16 weeks of DAA therapy resulted in excellent cure rates.…”

Section: Introductionmentioning

confidence: 99%

“…There has been a surge in the availability of hepatitis C virus (HCV) nucleic acid test (NAT) positive deceased donor kidneys (D+) due to an opioid epidemic in North America 1 2,3 . HCV D+ kidneys have historically been associated with a high discard rate 2 …”

Section: Introductionmentioning

confidence: 99%

“…This is due to the fact that the opioid epidemic has led to an increase in the number of persons who inject drugs, and this population accounts for 60% of new HCV infections in the United States annually 2,3 . HCV D+ kidneys have historically been associated with a high discard rate 2 …”

Section: Introductionmentioning

confidence: 99%

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Outcomes of short-duration antiviral prophylaxis for hepatitis C positive donor kidney transplants

Gupta

Yakubu

Zhang

et al. 2021

American Journal of Transplantation

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Trials describing 4-to 12-week courses of direct-acting antiviral drugs (DAAs) to treat hepatitis C virus (HCV) transmission from infected donors to uninfected kidney transplant recipients (D+/R− transplants) may be limited in "real-world" application by costs and delayed access to DAAs. We previously reported HCV transmission of 13% among D+/R− transplants with 2-to 4-day pangenotypic sofosbuvir/velpatasvir (SOF/VEL) perioperative prophylaxis, where one patient with HCV transmission was a nonresponder to first-line full-course DAA. Here, we report new data with a 7day prophylaxis protocol (N = 50), as well as cumulative treatment and outcome data on all HCV D+/R− transplants (N = 102). Overall, nine patients (9/102; 9%; 95% CI: 5%-16%) developed HCV transmission, with a significant decline noted in the 7-day group (2/50; 4%; 95% CI: 0%-13%) compared with 2-to 4-day prophylaxis (7/52; 13%; 95% CI: 5%-25%). All patients with HCV transmission achieved sustained virologic response post full-course therapy (including one nonresponder from initial trial). A 1:1 matched analysis (N = 102) with contemporary HCV D−/R− transplants (controls) showed that although the pretransplant wait time was significantly shorter for D+/ R− compared with D−/R− (mean: 1.8 vs. 4.4 years; p < .001), there were no differences in infections, rejection, development of de novo donor-specific antibody, or transplant outcomes up to 6 months of transplant.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Outcomes of short-duration antiviral prophylaxis for hepatitis C positive donor kidney transplants

Gupta

Yakubu

Zhang

et al. 2021

American Journal of Transplantation

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“…The impact of the opioid epidemic in the United States on public health extends beyond opioid-related fatalities. Additional public health consequences related to opioid misuse and opioid use disorders include an increase in HIV/hepatitis C virus infections and other infections among persons who inject drugs [ 8 - 10 ]. The United States Centers for Disease Control and Prevention reported that, in 2018, 1 in 15 new HIV diagnoses in the United States occurred among persons who inject drugs [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Health Behavior Survey Among People Who Use Opioids: Protocol for Implementing Technology-Based Rapid Response Surveillance in Community Settings

Frew¹,

Randall²,

King³

et al. 2021

JMIR Res Protoc

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Background In 2018, 2 million Americans met the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition diagnostic criteria for an opioid use disorder, and 9.9 million Americans had misused prescription pain relievers the previous year. Despite a rapid increase in opioid misuse, opioid use disorders, and overdoses, data are limited on the behavioral and contextual risks as well as the protective factors fueling the opioid epidemic in some hard hit US cities—Atlanta, Los Angeles, and Las Vegas. Opioid use also contributes to the risk of other health problems such as HIV and hepatitis C virus infections or mental health disorders and is linked to behavioral and environmental risks (eg, homelessness, experiences of violence, involvement in the justice system). Knowledge of the relationships between these linked vulnerabilities and how they influence service utilization is critical to effective policy and interventions. Objective This survey explores the relationships between demographic and economic characteristics, behavioral and environmental risk factors, and service utilization of people who use opioids to inform public health practice, policy, and future efforts to mitigate the risks faced by this population experiencing multiple health, social, and economic vulnerabilities. The results of this survey will be used to identify needs and intervention points for people who use drugs currently served by public health organizations. Methods We implemented a community-engaged strategy that involved development and execution of a two-stage purposive sampling plan involving selection of partner organizations (syringe exchange programs in urban settings) and recruitment and enrollment of participants aged 18-69 years served by these organizations in Atlanta, Los Angeles, and Las Vegas from 2019 to 2020. The recruited participants completed a survey, including a variety of measures to assess health (physical and mental) and health behaviors such as sexual behavior, vaccine receipt, and HIV/ hepatitis C virus infection testing. Additional items assessed drug use and misuse, syringe exchange and health service utilization, sex exchange, histories of interpersonal violence, and vaccine confidence. Results This protocol was successfully implemented despite challenges such as real-time technology issues and rapidly finding and surveying a difficult-to-reach population. We sampled 1127 unique participants (248 in Atlanta, 465 in Los Angeles, and 414 in Las Vegas). Conclusions The establishment and utilization of strong community partnerships enabled the rapid collection of data from a typically difficult-to-reach population. Local efforts such as these are needed to develop policies and practices that promote harm reduction among people who use opioids. International Registered Report Identifier (IRRID) RR1-10.2196/25575

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Missed opportunities for prevention: prevalence and incidence of human immunodeficiency virus and hepatitis C virus diagnoses among a cohort of individuals discharged from an urban hospital with injection drug-related diagnoses, 2012–2019

Evans

Vettese

Wortley

et al. 2023

Annals of Epidemiology

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High prevalence of injection drug use and blood-borne viral infections among patients in an urban emergency department

Cited by 23 publications

References 24 publications

Outcomes of short-duration antiviral prophylaxis for hepatitis C positive donor kidney transplants

Outcomes of short-duration antiviral prophylaxis for hepatitis C positive donor kidney transplants

Health Behavior Survey Among People Who Use Opioids: Protocol for Implementing Technology-Based Rapid Response Surveillance in Community Settings

Missed opportunities for prevention: prevalence and incidence of human immunodeficiency virus and hepatitis C virus diagnoses among a cohort of individuals discharged from an urban hospital with injection drug-related diagnoses, 2012–2019

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