Serious Bacterial Infections and Hepatitis C Virus Among People Who Inject Drugs: A Syndemic or Intertwined Epidemics?
Limited research has examined the possible synergistic interrelationships between serious bacterial infections (SBIs) of the heart (i.e., endocarditis), bone, spine, brain, or joints (e.g., osteomylelitis) and hepatitis C virus (HCV) infections. We examined whether syndemic interactions existed betw...
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2025-01-01
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| author | Thomas J. Stopka Robin M. Nance L. Sarah Mixson Hunter Spencer Judith I. Tsui Judith M. Leahy Mai T. Pho Jean DeJace Judith Feinberg April M. Young Wei-Teng Yang Amelia Baltes Eric Romo Randall T. Brown Kerry Nolte William C. Miller William A. Zule Wiley D. Jenkins Joseph A. Delaney Peter D. Friedmann |
| author_facet | Thomas J. Stopka Robin M. Nance L. Sarah Mixson Hunter Spencer Judith I. Tsui Judith M. Leahy Mai T. Pho Jean DeJace Judith Feinberg April M. Young Wei-Teng Yang Amelia Baltes Eric Romo Randall T. Brown Kerry Nolte William C. Miller William A. Zule Wiley D. Jenkins Joseph A. Delaney Peter D. Friedmann |
| author_sort | Thomas J. Stopka |
| collection | DOAJ |
| description | Limited research has examined the possible synergistic interrelationships between serious bacterial infections (SBIs) of the heart (i.e., endocarditis), bone, spine, brain, or joints (e.g., osteomylelitis) and hepatitis C virus (HCV) infections. We examined whether syndemic interactions existed between SBI, HCV, and substance-use-related factors in rural communities, hypothesizing that injection-mediated risks elevated the likelihood for both SBIs and HCV infections, which could be exacerbated by synergistic biological–biological or biological and social interactions. We calculated the prevalence ratios (PRs) of past-year SBI associated with each risk factor in separate models. Effect modification among significant risk factors was assessed using multiplicative interaction. Among 1936 participants, 57% were male and 85% White, with a mean age of 36 years. Eighty-nine participants (5%) reported hospitalization for an SBI in the year prior to the survey. More than half tested HCV-antibody-positive (58%); 62 (5.6%) of the participants with a positive HCV antibody result reported past-year hospitalization with an SBI. Injection behaviors were correlated with other SBI risk factors, including multiple injections in the same injection event (MIPIE), injection equipment sharing, and fentanyl use. In adjusted models, MIPIE (PR: 1.79; 95% confidence interval [CI]: 1.03, 3.11) and fentanyl use (PR: 1.68; 95% CI: 1.04, 2.73) were significantly associated with past-year SBI. Our analyses pointed to co-occurring epidemics of SBI and HCV, related to the cumulative health effects of fentanyl use contributing to frequent injections and MIPIE. Both the SBI and HCV epidemics present public health challenges and merit tailored interventions. |
| format | Article |
| id | doaj-art-c248f837bed64842a8ad27f2255f8aad |
| institution | Kabale University |
| issn | 2414-6366 |
| language | English |
| publishDate | 2025-01-01 |
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| series | Tropical Medicine and Infectious Disease |
| spelling | doaj-art-c248f837bed64842a8ad27f2255f8aad2025-01-24T13:51:23ZengMDPI AGTropical Medicine and Infectious Disease2414-63662025-01-011011710.3390/tropicalmed10010017Serious Bacterial Infections and Hepatitis C Virus Among People Who Inject Drugs: A Syndemic or Intertwined Epidemics?Thomas J. Stopka0Robin M. Nance1L. Sarah Mixson2Hunter Spencer3Judith I. Tsui4Judith M. Leahy5Mai T. Pho6Jean DeJace7Judith Feinberg8April M. Young9Wei-Teng Yang10Amelia Baltes11Eric Romo12Randall T. Brown13Kerry Nolte14William C. Miller15William A. Zule16Wiley D. Jenkins17Joseph A. Delaney18Peter D. Friedmann19Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USADepartment of Medicine, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195, USADepartment of Medicine, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195, USADepartment of Medicine, Oregon Health & Science University, Portland, OR 97239, USADepartment of Medicine, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195, USASOR Harm Reduction and Public Health Strategist, Behavioral Health Division, Oregon Health Authority, Portland, OR 97232, USADepartment of Medicine, Section of Infectious Diseases & Global Health, University of Chicago, Chicago, IL 60637, USADivision of Infectious Disease, Department of Medicine, University of Vermont, Burlington, VT 05401, USADepartments of Behavioral Medicine and Psychiatry & Medicine/Infectious Diseases, West Virginia University School of Medicine, Morgantown, WV 26505, USADepartment of Epidemiology and Environmental Health, University of Kentucky College of Public Health, Lexington, KY 40536, USADivision of Infectious Diseases, Perelman School of Medicine, Center for Addiction Medicine and Policy, University of Pennsylvania, Philadelphia, PA 19104, USADepartment of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USADepartment of Family Medicine, Boston Medical Center, Boston, MA 02118, USADepartment of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USADepartment of Nursing, University of New Hampshire, Durham, NH 03824, USADepartment of Epidemiology, Gillings School of Global Public Health, Chapel Hill, NC 27514, USADivision of Behavioral Health and Criminal Justice Research, RTI International, Research Triangle Park, NC 27709, USADepartment of Public Health Sciences, Clemson University, Clemson, SC 29634, USADepartment of Medicine, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195, USAOffice of Research and Department of Healthcare Delivery & Population Sciences, University of Massachusetts Chan Medical School—Baystate and Baystate Health, Springfield, MA 01107, USALimited research has examined the possible synergistic interrelationships between serious bacterial infections (SBIs) of the heart (i.e., endocarditis), bone, spine, brain, or joints (e.g., osteomylelitis) and hepatitis C virus (HCV) infections. We examined whether syndemic interactions existed between SBI, HCV, and substance-use-related factors in rural communities, hypothesizing that injection-mediated risks elevated the likelihood for both SBIs and HCV infections, which could be exacerbated by synergistic biological–biological or biological and social interactions. We calculated the prevalence ratios (PRs) of past-year SBI associated with each risk factor in separate models. Effect modification among significant risk factors was assessed using multiplicative interaction. Among 1936 participants, 57% were male and 85% White, with a mean age of 36 years. Eighty-nine participants (5%) reported hospitalization for an SBI in the year prior to the survey. More than half tested HCV-antibody-positive (58%); 62 (5.6%) of the participants with a positive HCV antibody result reported past-year hospitalization with an SBI. Injection behaviors were correlated with other SBI risk factors, including multiple injections in the same injection event (MIPIE), injection equipment sharing, and fentanyl use. In adjusted models, MIPIE (PR: 1.79; 95% confidence interval [CI]: 1.03, 3.11) and fentanyl use (PR: 1.68; 95% CI: 1.04, 2.73) were significantly associated with past-year SBI. Our analyses pointed to co-occurring epidemics of SBI and HCV, related to the cumulative health effects of fentanyl use contributing to frequent injections and MIPIE. Both the SBI and HCV epidemics present public health challenges and merit tailored interventions.https://www.mdpi.com/2414-6366/10/1/17serious bacterial infectionshepatitis C virusruralpeople who inject drugssyndemic |
| spellingShingle | Thomas J. Stopka Robin M. Nance L. Sarah Mixson Hunter Spencer Judith I. Tsui Judith M. Leahy Mai T. Pho Jean DeJace Judith Feinberg April M. Young Wei-Teng Yang Amelia Baltes Eric Romo Randall T. Brown Kerry Nolte William C. Miller William A. Zule Wiley D. Jenkins Joseph A. Delaney Peter D. Friedmann Serious Bacterial Infections and Hepatitis C Virus Among People Who Inject Drugs: A Syndemic or Intertwined Epidemics? Tropical Medicine and Infectious Disease serious bacterial infections hepatitis C virus rural people who inject drugs syndemic |
| title | Serious Bacterial Infections and Hepatitis C Virus Among People Who Inject Drugs: A Syndemic or Intertwined Epidemics? |
| title_full | Serious Bacterial Infections and Hepatitis C Virus Among People Who Inject Drugs: A Syndemic or Intertwined Epidemics? |
| title_fullStr | Serious Bacterial Infections and Hepatitis C Virus Among People Who Inject Drugs: A Syndemic or Intertwined Epidemics? |
| title_full_unstemmed | Serious Bacterial Infections and Hepatitis C Virus Among People Who Inject Drugs: A Syndemic or Intertwined Epidemics? |
| title_short | Serious Bacterial Infections and Hepatitis C Virus Among People Who Inject Drugs: A Syndemic or Intertwined Epidemics? |
| title_sort | serious bacterial infections and hepatitis c virus among people who inject drugs a syndemic or intertwined epidemics |
| topic | serious bacterial infections hepatitis C virus rural people who inject drugs syndemic |
| url | https://www.mdpi.com/2414-6366/10/1/17 |
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