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HIV Infection Linked to Injection Use of Oxymorphone in Indiana, 2014-2015.
- Source :
-
New England Journal of Medicine . 7/21/2016, Vol. 375 Issue 3, p229-239. 11p. - Publication Year :
- 2016
-
Abstract
- <bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>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.). [ABSTRACT FROM AUTHOR]
- Subjects :
- *HIV infection risk factors
*EPIDEMICS
*HIV
*HEPATITIS C virus
*SEXUAL partners
Subjects
Details
- Language :
- English
- ISSN :
- 00284793
- Volume :
- 375
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- New England Journal of Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 116944142
- Full Text :
- https://doi.org/10.1056/NEJMoa1515195