Prevention Program Seeks to Combat Opioid-Induced HIV, Hepatitis C Virus Epidemics

West Virginia University will lead a new federally-funded program that seeks to disrupt the cycle of infectious disease outbreaks caused by the opioid epidemic, according to a press release.

Drug overdoses are the leading cause of accidental deaths in the United States, with 52,404 fatal drug overdoses in 2015. According to the American Society of Addiction Medicine, opioids are the primary driver of the epidemic, with 20,101 overdose deaths related to prescription painkillers, and 12,990 related to heroin in 2015.

“West Virginia has the highest drug overdose fatality and hepatitis rates in the US,” Judith Feinberg, MD, WVU School of Medicine, said in the release. “We have not seen an HIV outbreak yet. But it’s a ticking time bomb for us, especially in rural areas where the local health system’s ability to detect and mitigate an HIV outbreak may not be well developed.”

The program is a combination of research, health care services, and community involvement in harm reduction strategies. It will target 8 counties in West Virginia: Boone, Kanawha, Logan, McDowell, Mercer, Mingo, Raleigh, and Wyoming.

Data from the CDC and West Virginia reveal 6 the 8 counties are among the top 25 counties in the United States in per capita overdose fatality rates.

“The threat of an HIV outbreak here is among the highest in the US,” Gordon Smith, MD, MPH, professor at WVU School of Public Health said in the release. “Based on the CDC’s analysis of a 2014-15 outbreak of HIV and hepatitis C in rural Indiana, and the high rates of poverty, overdose deaths, and hepatitis B and C infections we see in this region, it would not take long for a small number of HIV cases to set off a serious health crisis.”

The project, titled Rural West Virginia Responds to Opioid Injection Epidemics: From Data to Action, is supported by a 2-year $1,010,068 grant from the National Institute of Drug Abuse, the CDC, and the Appalachian Regional Commission. Feinberg and Smith are set to co-lead the project.

Through a partnership with local communities, the project will develop an integrated prevention, harm reduction, and treatment team across the region to rapidly identify and mitigate small HIV microepidemics and prevent them from spreading, according to the release.

“The success of this approach will be driven by input from local communities and public health agencies,” Feinberg said. “We will work with them to coordinate and improve screening, prevention, and treatment for hepatitis C, HIV, and other infections associated with injection drug use.”

The project is also supported by the Substance Abuse and Mental Health Services Administration and the West Virginia Clinical and Translational Science Institute.

“The first phase is a 2-year effort to develop an evidence-based road map, working with local communities and public health agencies, to coordinate and improve screening, prevention, and treatment for hepatitis C, HIV, and other associated diseases,” Smith noted. “It also involves developing a novel strategy to rapidly identify communities and use it to target communities at highest risk. If this first planning phase is successful, increased funding for a further 3 years will enable implementation of a comprehensive program to prevent the devastating effects of injection drug use in this hard-hit communities.”