Opioids and Infectious Diseases: A Converging Public Health Crisis

Schwetz, Tara A.; Calder, Thomas; Rosenthal, Elana; Kattakuzhy, Sarah; Fauci, Anthony S.

doi:10.1093/infdis/jiz133

Cited by 74 publications

(53 citation statements)

References 21 publications

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“…When it comes to the use of recreational drugs, also referred to as "sexualized drug use," extreme situations may develop in such venues, in particular "chemsex" or swinger settings [66] [67]. That is, using increasing rates of "recreational" party drugs up to opioids when having sex [68] [69] [70] [71]. Such cluster meetings of the vulnerable groups mentioned here have consequences: As the relative compaction of HIV-infected people both with and without cART is higher during these meetings than in situations of casual dates, these cluster arrangements provide a favorable potential for more effective spread of HIV and other STIs.…”

Section: Modern Trendsmentioning

confidence: 99%

HIV Prevention Concepts—Counter Movements Challenging Societies

Dennin¹,

Sinn²

2020

WJA

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This article focuses on emerging trends conflicting current HIV prevention concepts. We address developments in Europe where similar HIV prevention strategies are applied. With epidemiological, time-staggered records from a European institution, we show how ineffective HIV prevention measures have turned out. The decision-makers responsible for these prevention concepts have ignored a multitude of individual motivations from people responsible for the spread of HIV. Both the legal classification of the messages of the prevention campaigns and the obligations of those affected by HIV concerning their social responsibility are analyzed. There are published requirements for updated, multisectoral prevention campaigns. They focus on the intensification of HIV testing concepts to reduce the proportion of late presenters and to link key populations of various kinds to medical and social care services. Four categories present relevant issues with the potential to combine them into suitable arrangements for new prevention concepts.

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Section: Modern Trendsmentioning

confidence: 99%

HIV Prevention Concepts—Counter Movements Challenging Societies

Dennin¹,

Sinn²

2020

WJA

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“…The augmented use of IDU within the opioid epidemic has led to an increase in viral infections, such as HIV and hepatitis C virus (HCV). HIV and HCV infections are transmitted between individuals through high-risk injection practices, such as sharing syringes, drug paraphernalia, and high dead-space syringes [ 44 ]. Another mode of transmission is unprotected sex, in which one study reported its increase in individuals using non-medical prescription opioids [ 45 ].…”

Section: Viral Infectionsmentioning

confidence: 99%

“…In 2016, injection opioid use was responsible for 13% of new HIV diagnoses and linked to localized outbreaks in Scott County, Indiana and Lawrence and Lowell, Massachusetts [ 44 ]. PWID accounted for 9% (3641/38,739) of new HIV diagnoses in the USA in 2017 [ 46 ].…”

Section: Viral Infectionsmentioning

confidence: 99%

Emerging Viral and Bacterial Infections: Within an Era of Opioid Epidemic

et al. 2020

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The opioid epidemic is a public health crisis that continues to impact healthcare in the United States of America (USA). While changes in opioid prescribing have curbed the medical use of opioids, the increase in nonmedical use, largely driven by injection drug use (IDU), has contributed to the escalating incidence of opioid use disorder (OUD). Furthermore, IDU is associated with high-risk injection practices that can increase the risk of acquiring viral and bacterial infections. Here in this comprehensive review, we aimed to summarize the epidemiology and management of OUD, along with the screening and antimicrobial treatment of associated infections, specifically focused on human immunodeficiency virus, hepatitis C virus, skin and soft tissue infections, endocarditis, and osteomyelitis. Medication-assisted therapy (MAT) and infection guidelines from the USA will be presented.

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“…Emerging literature suggests that certain classes of opioids interact with nonclassical ORs in the CNS, leading to complex physiological regulation (18). In the United States, pharmacological and street opioid use has reached epidemic proportions (19). There are conflicting reports on the net outcome of opioid exposure to the adaptive immune system (5), but the overall profile seems to be immunoinhibitory, limiting inflammation and autoimmunity.…”

Section: Introductionmentioning

confidence: 99%

Transcriptomic Analysis Reveals Receptor Subclass–Specific Immune Regulation of CD8+ T Cells by Opioids

2020

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Opioid peptides are released at sites of injury, and their cognate G protein-coupled opioid receptors (OR) are expressed on immune cells. Exposure of human circulating CD8 + T cells to selective OR agonists differentially regulates thousands of genes. Gene set enrichment analysis reveals that m-OR more strongly regulates cellular processes than d-OR. In TCR naive T cells, triggering m-OR exhibits stimulatory and inhibitory patterns, yet when administered prior to TCR cross-linking, a m-OR agonist inhibits activation. m-OR, but not d-OR, signaling is linked to upregulation of lipid, cholesterol, and steroid hormone biosynthesis, suggesting lipid regulation is a mechanism for immune suppression. Lipid rafts are cholesterol-rich, liquid-ordered membrane domains that function as a nexus for the initiation of signal transduction from surface receptors, including TCR and m-OR. We therefore propose that m-OR-specific inhibition of TCR responses in human CD8 + T cells may be mediated through alterations in lipid metabolism and membrane structure. ImmunoHorizons, 2020, 4: 420-429.

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Opioids and Infectious Diseases: A Converging Public Health Crisis

Cited by 74 publications

References 21 publications

HIV Prevention Concepts—Counter Movements Challenging Societies

HIV Prevention Concepts—Counter Movements Challenging Societies

Emerging Viral and Bacterial Infections: Within an Era of Opioid Epidemic

Transcriptomic Analysis Reveals Receptor Subclass–Specific Immune Regulation of CD8+ T Cells by Opioids

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