CDC Alert: HIV And Hepatitis C Co-Infection Outbreaks Could Result From IV Drug Use

IV Drug
The CDC issued an alert today to warn of HIV and hepatitis C virus community outbreaks resulting from IV drug use. Reuters

The Centers for Disease Control and Prevention issued a Health Alert Network Advisory today to warn public health departments and medical providers of HIV and hepatitis C virus co-infection outbreaks resulting from IV drug use. The emergency advisory refers to the recent Indiana epidemic, where health officials identified 142 persons newly infected with HIV in a rural community of 4,200 people in Scott County. In the past, fewer than five new infections have been identified in the southeastern county annually.

The majority of these new HIV patients, 84 percent, are co-infected with hepatitis C virus (HCV), according to the CDC. At least five of the total cases occurred in nearby Jackson County, Reuters reported. Meanwhile officials believe more cases will be discovered in the area shortly.

“Urgent action is needed to prevent further HIV and HCV transmission in this area and to investigate and control any similar outbreaks in other communities,” the CDC advisory states.

Nationally, hepatitis C infections have increased 150 percent between the years 2010 and 2013. Over 70 percent of long-term IV drug users may be infected with this virus, the CDC notes. Rates of Hep C infection are increasing among young nonurban IV drug users in particular, with rising rates linked to the abuse of injected prescription-type opioids. In nonurban counties east of the Mississippi River, these increases have been most substantial. 

Though the investigation of the Indiana outbreak is not finished, the overwhelming majority (96 percent) of those infected with HIV reported using injected drugs. An estimated eight percent of the annual 50,000 new HIV infections nationwide arise from IV drug use. With regard to Hep C, the most frequent mode of transmission is via shared drug-injecting equipment.

The CDC recommends all state health officials review data on HIV diagnoses, HCV diagnoses, overdose deaths, drug treatment admissions, and drug arrests. Communities at risk for clusters of co-infection include those with recent increases in the number of HIV infections attributed to IV drug use and recent increases in the number of HCV infections. Communities with high rates of IV drug use also are at-risk. Additionally, CDC proposes contact tracing for all new HIV diagnoses and routine testing of all contacts for both HIV and HCV.

With regard to doctors and other health care providers, CDC suggests all patients diagnosed with Hep C also be tested for HIV, while those testing positive for HIV also be tested for Hep C. Providers should also encourage testing of syringe-sharing and sexual partners of infected people, while reporting all newly diagnosed infections to the health department.

Doctors need to address the risks and benefits of pain treatment options with any patient under consideration for pain management. They should be informed that long-term therapy with opioid drugs, such as OxyContin, has not been proven to reduce chronic pain.

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