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HIV Infection Linked to Injection Use of Oxymorphone in Indiana, 2014–2015
Open accessAbstract
BACKGROUND: In January 2015, a total of 11 new diagnoses of human immunodeficiency virus (HIV) infection were reported in a small community in Indiana. We investigated the extent and cause of the outbreak and implemented control measures. METHODS: We identified an outbreak-related case as laboratory-confirmed HIV infection newly diagnosed after October 1, 2014, in a person who either resided in Scott County, Indiana, or was named by another case patient as a syringe-sharing or sexual partner. HIV polymerase (pol) sequences from case patients were phylogenetically analyzed, and potential risk factors associated with HIV infection were ascertained. RESULTS: From November 18, 2014, to November 1, 2015, HIV infection was diagnosed in 181 case patients. Most of these patients (87.8%) reported having injected the extended-release formulation of the prescription opioid oxymorphone, and 92.3% were coinfected with hepatitis C virus. Among 159 case patients who had an HIV type 1 pol gene sequence, 157 (98.7%) had sequences that were highly related, as determined by phylogenetic analyses. Contact tracing investigations led to the identification of 536 persons who were named as contacts of case patients; 468 of these contacts (87.3%) were located, assessed for risk, tested for HIV, and, if infected, linked to care. The number of times a contact was named as a syringe-sharing partner by a case patient was significantly associated with the risk of HIV infection (adjusted risk ratio for each time named, 1.9; P<0.001). In response to this outbreak, a public health emergency was declared on March 26, 2015, and a syringe-service program in Indiana was established for the first time. CONCLUSIONS: Injection-drug use of extended-release oxymorphone within a network of persons who inject drugs in Indiana led to the introduction and rapid transmission of HIV. (Funded by the state government of Indiana and others.).
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The triple wave epidemic: Supply and demand drivers of the US opioid overdose crisis
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Metadata
- Authors
- Peters, P. J., Pontones, P., Hoover, K. W., Patel, M. R., Galang, R. R., Shields, J., Blosser, S. J., Spiller, M. W., Combs, B., Switzer, W. M., Conrad, C., Gentry, J., Khudyakov, Y., Waterhouse, D., Owen, S. M., Chapman, E., Roseberry, J. C., McCants, V., Weidle, P. J., Broz, D., Samandari, T., Mermin, J., Walthall, J., Brooks, J. T., & Duwve, J. M.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2016-07-21
- Volume
- 375
- Issue
- 3
- Pages
- 229-239
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2494835558
- Cited by
- 594
- References
- 23
- FWCI
- 56.97
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Peters, P. J., Pontones, P., Hoover, K. W., Patel, M. R., Galang, R. R., Shields, J., Blosser, S. J., Spiller, M. W., Combs, B., Switzer, W. M., Conrad, C., Gentry, J., Khudyakov, Y., Waterhouse, D., Owen, S. M., Chapman, E., Roseberry, J. C., McCants, V., Weidle, P. J., . . . Duwve, J. M. (2016). HIV Infection Linked to Injection Use of Oxymorphone in Indiana, 2014–2015. New England Journal of Medicine. https://doi.org/10.1056/nejmoa1515195
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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